DOI QR코드

DOI QR Code

A brief report on a technical description of ultrasound-guided lumbar sympathetic block

  • Moon, Jee Youn (Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Choi, Jae Kyu (Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Shin, Ji Yeon (Department of Anesthesiology and Pain Medicine, National Police Hospital) ;
  • Chon, Sung Won (Department of Anesthesiology and Pain Medicine, National Police Hospital) ;
  • Dev, Sushmitha (Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine)
  • Received : 2016.09.19
  • Accepted : 2016.11.09
  • Published : 2017.01.01

Abstract

The lumbar sympathetic ganglion block (LSGB) is widely used for diagnosing and treating sympathetically maintained pain disorders. The LSGB has been conventionally carried out under fluoroscopy or computed tomography guidance. However, as ultrasound technology improved, ultrasound-guided interventions have been expanding their territory to deeper structures. Ultrasound guidance provides many benefits including protecting vascular injection, shortening procedure time in some cases, and reducing the emission of radiation. In this report, we describe a successful case of a US-guided LSGB without major complications. We expect that US-guided LSGBs can be implemented and furnished in the daily outpatient clinical setting by highly trained pain physicians.

Keywords

References

  1. Chaturvedi A, Dash HH. Sympathetic blockade for the relief of chronic pain. J Indian Med Assoc 2001; 99: 698-703.
  2. Rigaud J, Delavierre D, Sibert L, Labat JJ. Sympathetic nerve block in the management of chronic pelvic and perineal pain. Prog Urol 2010; 20: 1124-31. https://doi.org/10.1016/j.purol.2010.08.047
  3. Oi Y, Nakamura K, Sakamoto A, Ogawa R, Watari J, Okajima Y, et al. Helical CT guided lumar sympathetic ganglion block. Masui 1996; 45: 888-91.
  4. Manchikanti L, Cash KA, Moss TL, Pampati V. Radiation exposure to the physician in interventional pain management. Pain Physician 2002; 5: 385-93.
  5. Jee H, Lee JH, Kim J, Park KD, Lee WY, Park Y. Ultrasoundguided selective nerve root block versus fluoroscopy-guided transforaminal block for the treatment of radicular pain in the lower cervical spine: a randomized, blinded, controlled study. Skeletal Radiol 2013; 42: 69-78. https://doi.org/10.1007/s00256-012-1434-1
  6. Park Y, Lee JH, Park KD, Ahn JK, Park J, Jee H. Ultrasound-guided vs. fluoroscopy-guided caudal epidural steroid injection for the treatment of unilateral lower lumbar radicular pain: a prospective, randomized, single-blind clinical study. Am J Phys Med Rehabil 2013; 92: 575-86. https://doi.org/10.1097/PHM.0b013e318292356b
  7. Narouze S. Ultrasound-guided stellate ganglion block: safety and efficacy. Curr Pain Headache Rep 2014; 18: 424. https://doi.org/10.1007/s11916-014-0424-5
  8. Gofeld M, Lee CW. Ultrasound-guided superior hypogastric plexus block: a cadaveric feasibility study with fluoroscopic confirmation. Pain Pract 2016 [in press].
  9. Moura RN, De Moura EG, Bernardo WM, Otoch JP, Bustamante FA, Albers DV, et al. Endoscopic-ultrasound versus percutaneous-guided celiac plexus block for chronic pancreatitis pain. A systematic review and meta-analysis. Rev Gastroenterol Peru 2015; 35: 333-41.
  10. Kirvela O, Svedstrom E, Lundbom N. Ultrasonic guidance of lumbar sympathetic and celiac plexus block: a new technique. Reg Anesth 1992; 17: 43-6.
  11. Harden RN, Bruehl S, Stanton-Hicks M, Wilson PR. Proposed new diagnostic criteria for complex regional pain syndrome. Pain Med 2007; 8: 326-31. https://doi.org/10.1111/j.1526-4637.2006.00169.x
  12. Nordmann GR, Lauder GR, Grier DJ. Computed tomography guided lumbar sympathetic block for complex regional pain syndrome in a child: a case report and review. Eur J Pain 2006; 10: 409-12. https://doi.org/10.1016/j.ejpain.2005.05.006
  13. Finlayson RJ, Etheridge JP, Tiyaprasertkul W, Nelems B, Tran DQ. A randomized comparison between ultrasound- and fluoroscopy-guided c7 medial branch block. Reg Anesth Pain Med 2015; 40: 52-7. https://doi.org/10.1097/AAP.0000000000000186
  14. Karmakar MK, Ho AM, Li X, Kwok WH, Tsang K, Ngan Kee WD. Ultrasound-guided lumbar plexus block through the acoustic window of the lumbar ultrasound trident. Br J Anaesth 2008; 100: 533-7. https://doi.org/10.1093/bja/aen026
  15. Kim DH, Kim KH, Kim YC. Minimally invasive percutaneous spinal techniques. Philadelphia (PA), Elsevier. 2011.
  16. Kim WH, Kim SK, Lee CJ, Kim TH, Sim WS. Determination of adequate entry angle of lumbar sympathetic ganglion block in Korean. Korean J Pain 2010; 23: 11-7. https://doi.org/10.3344/kjp.2010.23.1.11
  17. Rossel T, Kersting S, Heller AR, Koch T. Combination of high-resolution ultrasound-guided perivascular regional anesthesia of the internal carotid artery and intermediate cervical plexus block for carotid surgery. Ultrasound Med Biol 2013; 39: 981-6. https://doi.org/10.1016/j.ultrasmedbio.2013.01.002
  18. Meng S, Lieba-Samal D, Reissig LF, Gruber GM, Brugger PC, Platzgummer H, et al. High-resolution ultrasound of the posterior femoral cutaneous nerve: visualization and initial experience with patients. Skeletal Radiol 2015; 44: 1421-6. https://doi.org/10.1007/s00256-015-2177-6

Cited by

  1. Ultrasound-Assisted Versus Fluoroscopic-Guided Lumbar Sympathetic Ganglion Block vol.126, pp.4, 2018, https://doi.org/10.1213/ANE.0000000000002640
  2. Ganglion blocks as a treatment of pain: current perspectives vol.10, pp.None, 2017, https://doi.org/10.2147/jpr.s134775
  3. Ultrasound lumbar sympathetic block: Out of plane approach with insulated stimulation needle - Case series of three patients vol.64, pp.2, 2017, https://doi.org/10.4103/ija.ija_686_19