Several aspects of stellate ganglion block

  • E. P. Yevstratov Odrex Medical House, Odessa
  • N. V. Krupskaya Odessa Regional Clinical Hospital
  • V. Y. Shumlyanskiy Odessa National Medical University
Keywords: Stellate ganglion block, Horner’s syndrome, transcranial doppler

Abstract

Background and Study Goal. Stellate ganglion block (SGB) has been used in the treatment of cerebral derangements associated with headache, for the purpose of reliving spasm and presumably increasing the cerebral blood flow, normalizing endovascular resistance.

Materials and Methods. 30 volunteers underwent unilateral SGB, 30–40 years (21 females, 9 males), with cluster headache. 5 ml 0,25 % ropivacaine were administered + 4 mg dexamethasone under C6 level paratracheal ultrasound guid. The confirmation was the presence of Horner´s syndrome. The resistive index (RI) was measured by ultrosound transcranial CV doppler of middle cerebral artery at the baseline and 1 min, and 10 min after SGB on both sides (the other side was taken for control). Normal values of RI corresponded to the age.

Results and discussion. Our observations showed that after SGB in all patients there was a significant change in RI with normalization of cerebral blood flow, reduction or disappearance of headache.

Conclusions. The difference between the block and the nonblock sides was significant before procedure (p < 0,0001) and after 10 min become the same with an insignificant difference (p = 0,001). A higher RI in patients with a cluster headache may be as an indicator for choosing the block side. Ultrasound technique will be helpfull for providing safe block and effect control.

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References

Hogan Q, Erickson SJ. MR imaging of the stellate ganglion; Normal appearance // AJR 1992; 158: 655- 659.

Hogan Q, Erickson S, Haddox D et al. The spread of solution during stellate ganglion block // Regional Anesthesia. 1992; 17: 78–83.

Hogan Q, Abram S. Neural blockade for diagnosis and prognosis // Anesthesiology. 1997; 86: 216–241.

Hartzler GO, Osborn MJ. Invasive electrophysiological study in the Jervell and Lange-Nielsen syndrome // Br Heart J. 1981; 45: 225–229.

Bonica JJ. Sympathetic nerve blocks for pain diagnosis and therapy. Technical considerations vol. II. Block of stellate ganglion and cervicothoracic and thoracic chains. Published by Winthrop – Breon laboratories. 1984; pp. 61–77.

Cook TG, de Sanctis CA, Plaza JA et al. Stellate ganglion block for sudden profound hearing loss // Anesthesiology. 1981; 54: 421– 423.

Malmqvist EL, Bengtsson M, Sorenson J. Efficacy of stellate ganglion block: A clinical study with bupivacaine // Reg Anesth. 1992; 17: 340–347.

Matsumoto S. Thermographic assessments of the sympathetic blockade by stellate ganglion (1); Comparison between C7-SGB and C6-SGB in patients // Masui. 1991; 40: 562–569.

Mastsumoto S. Thermographic assessment of the sympathetic blockade by stellate ganglion block (20); Comparison between C7-SGB and C6-SGB in 20 healthy volunteers // Masui. 1991; 40: 692–701.

Stevens RA, Stotz A, Kao TC et al. The relative increase in the skin temperature after stellatae ganglion block is predictive of complete sympathectomy of the hand // Reg Anesth Pain Med. 1998; 23: 266–270.

Elias M. The anterior approach for thoracic symphatetic ganglion block using a curved needle // Pain Clinic. 2000; 12: 17–24.

Sluijter M. Radiofrequency Lesion on the Treatment of Cervical Pain Syndrome. Boston, Radionics Corp, 1990.

Kuntz A. Distribution of the sympathetic rami to the brachial plexus: its relation to sympathectomy affecting the upper extremity // Arch Surg 1927; 15: 871–7.

Abdi S, Zhou Y, Patel N, Saini B, Nelson J. A new and easy technique to block the stellate ganglion // Pain Physician. 2004; 7: 327–31.

Published
2018-08-01
How to Cite
1.
Yevstratov EP, Krupskaya NV, Shumlyanskiy VY. Several aspects of stellate ganglion block. PMJUA [Internet]. 1Aug.2018 [cited 15Dec.2018];3(2):62-6. Available from: https://www.painmedicine.org.ua/index.php/pnmdcn/article/view/102
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Original article