The Korean Journal of Pain

The Korean Pain Society (대한통증학회)
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Effect of the Oblique Fluoroscopic Approach for Performing Stellate Ganglion Block

성상신경절 차단 시 빗김법의 효과

  • Park, Chan Hong (Department of Anesthesiology and Pain Medicine, School of Medicine, Catholic University of Daegu) ;
  • Lee, Do Seok (Department of Anesthesiology and Pain Medicine, School of Medicine, Catholic University of Daegu) ;
  • Kim, Bong Il (Department of Anesthesiology and Pain Medicine, School of Medicine, Catholic University of Daegu)
  • 박찬홍 (대구가톨릭대학교 의과대학 마취통증의학교실) ;
  • 이도석 (대구가톨릭대학교 의과대학 마취통증의학교실) ;
  • 김봉일 (대구가톨릭대학교 의과대학 마취통증의학교실)
  • Received : 2005.12.30
  • Accepted : 2006.04.21
  • Published : 2006.06.30
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Abstract

Background: Stellate ganglion block (SGB) is a selective sympathetic blockade that affects the head, neck and the upper extremities. It is an important method that has been frequently used in pain clinics due to its wide range of indications. But there were some problem with performing SGB at C6 or C7. Thus, various techniques have been recently introduced to successfully perform SGB; among them, there is the oblique approach. This study was performed to evaluate the effectiveness of the oblique approach for performing SGB in C7. Methods: Forty six patients with sudden hearing loss were studied. In group I, the patient underwent C7 oblique SGB with 1% mepivacaine (3 ml) under fluoroscopic guidance. In group II, the patients underwent the C7 classical anterior approach SGB with 1% mepivaine (5 ml) under fluoroscopic guidance. We compared the occurrence of Horner's syndrome, the side effects and the changes of temperature of the skin of the hand. Results: The rate of Horner's syndrome was 81.5% in the group I and 84.2% in the group II. The rate of incurring increased skin temperature (${\geq}34^{\circ}C$) of the fingers was 77.7% and 79.4% in each group, respectively. Conclusions: The C7 oblique approach for SGB showed the same SGB effect compared with the C7 anterior approach for SGB, and there were also fewer complications. We conclude that C7 oblique SGB may be a beneficial method for treating patients with this particular malady.

Keywords

References

  1. Raj PP, Anderson SR: Stellate ganglion block. In: lntetventional pain management. 2nd ed. Edited by Waldman SD: Philadelphia, Saunders. 2001, pp 363-72
  2. Meyer J: Indications and possibilities of blockade of sympathetic netve. Reg Anaesth 1987; 10: 55-8
  3. Wulf H, Maier C: Complication and side effects of stellate ganglion blockade, result of a questionnaire survey. Anaesthesist 1992; 4: 146-51
  4. Abdi S, Zhou Y, Doshi R, Patel N: Stellate ganglion block: emphasis on the new oblique fluoroscopic approach. Tech Reg Anesth Pain Med 2005; 9: 73-80 https://doi.org/10.1053/j.trap.2005.05.005
  5. Allen EV, Brown GE: Raynaud's disease: a critical review of minimal requisites for diagnosis. Am J Med Sci 1932; 183: 187-200 https://doi.org/10.1097/00000441-193202000-00004
  6. Haug O, Draper WL, Haug SA: Stellate ganglion blocks for idiopathic sensorineural hearing loss. Arch Otolaryngol 1976; 102: 5-8 https://doi.org/10.1001/archotol.1976.00780060051003
  7. Carron H, Litwillet R: Stellate ganglion block. Anesth Analg 1975; 54: 567-70
  8. Kim TY: Stellate ganglion block. In: Text book of pain clinic. Edited by The Korean Pain Sociery: Seoul, Koonja Publishing Inc. 2000, pp 370-7
  9. Malmqvist EL, Bengtsson M, Sorensen J: Efficacy of stellate ganglion block: a clinical study with bupivacaine. Reg Anesth 1992; 17: 340-7
  10. Raj PP: Practical management of pain. 2nd ed. Philadelphia, Morsby. 1992, pp 7-87
  11. Chrisrie JM, Martinez CR: Computerized axial tomography to define the distribution of solution after stellate ganglion nerve block. J Clin Anesth 1995; 7: 306-11 https://doi.org/10.1016/0952-8180(95)00037-I
  12. Lee HK, Chung SY, Yang SK, Lee HJ, Suh YS, Kim C: Minimal volume of local anesthetic fot successful stellate ganglion block. Korean J Pain 1995; 8: 60-4
  13. Linder HH: The anatomy of the fasciae of the face and neck with particular reference to the spread and treatment of inttaotal infections (Ludwig's) that have progtessed into adjacent fascial spaces. Ann Sutg 1986; 204: 705-14
  14. Hatdy PA, Wells JC: Extent of symapathetic blockade after stellate ganglion block with bupivacaine. Pain 1989; 36: 193-6 https://doi.org/10.1016/0304-3959(89)90023-7
  15. Christie JM, Martinez CR: Computerized axial romography to define the distribution of solution after stellate ganglion nerve block. J Clin Anesthesia 1995; 7: 306-11 https://doi.org/10.1016/0952-8180(95)00037-I
  16. Kang JG: The size and location of human stellate ganglion. Korean J Pain 1994; 7: 170-4
  17. Green NM: Physiology of spinal anesthesia. 3rd ed. Baltimore, William & Wilkins. 1981, pp 26-40
  18. Katz J: Skin blood flow after axillary brachial plexus block: use of laser doppler flowmetty. Reg Anesth 1984; 9: 68-9
  19. Holland AJC, Davies KH, Wallace DH: Sympathetic blockade of isolated limbs by intravenous guanethidine. Can Anaeth Soc J 1977; 24: 597-602 https://doi.org/10.1007/BF03005533