• The Korean Journal of Pain
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• v.10 no.1
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• pp.101-103
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• 1997

Common oral lesions of lichen planus (LP) are bilateral lace-like white patches in the buccal and lingual mucosae. Oral LP of chronic erosive and ulcerative forms develop carcinomas among approximately 1% of affected patients. A 64 year old male patient suffering from LP with early verrucous carcinoma on lips, tongue, and hard palate for approximately 8 years was refered to the pain clinic from department of dermatology. He complained of severe pain (VAS 9.5) on lips, oral cavity and left of the face. For 18 consecutive days we performed stellate ganglion blocks (SGB) with 6 ml on his left side of face. Patients pain decreased to (VAS 3.0) after 18 SGB. After a total of 31 SGB patient was discharged free of pain. pain recurred (VAS 3.5) 22 days after discharge. We then performed SGB, twice weekly and pain was effectively relieved after total 54 SGB. But patient needed to take oral analgesics due to nocturnal pain.

• The Korean Journal of Pain
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• v.10 no.1
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• pp.54-57
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• 1997

Background : The tonsillar region is innervated by the sensory components of the glossopharyngeal nerve(IX) which communicates with certain part of cervical sympathetic ganglion. Some authors suggest stellate ganglion block(SGB) is effective for treatment of recurrent tonsillitis. The goal of this study was to evaluate the effect of SGB in controlling pain after tonsillectomy. Methods : Forty five patients, evaluated to ASA class 1 and 2, scheduled for tonsillectomy under general anesthesia were randomly assigned to 1 of 3 groups (group I: control; group II: SGB with 1% lidocaine 5 ml; group III: SGB with 2% lidocaine 2.5 ml plus 0.5% bupivacaine 2.5 ml), SGB was performed at the end of surgery. Postoperative pain was assessed with Numeric Rating Scale(NRS) NRS assessment was made 30, 60, 90 min, 2 h, 4 h, 24 h, 48 h after tonsillectomy. Results : Pain scores, after 30 min in group II, III and 60, 90 min in group III were significantly lower than group I(p<0.05). Conclusions : We found SGB was effective in controlling pain after tonsillectomy but further studies are required needs to prolong duration of relief..

• The Korean Journal of Pain
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• v.14 no.1
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• pp.93-97
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• 2001

Facial nerve palsy is not a serious disease, but it can be both upsetting and disabling for patients. More than half of the lesions of facial nerve palsy fall into the category termed Bell's palsy. It is very rare to find a representative case of bilateral Bell's palsy. Here we report the changes of infrared thermographic findings in bilateral Bell's palsy treated with a stellate ganglion block (SGB). A 45-year-old female patient who had a right facial palsy which developed 2 weeks before. Steroid administration and acupuncture was not effective and so she was referred to pain clinic. The right facial palsy was cured after 19th right SGB. Twenty eight days after the onset of the right facial palsy, left facial palsy also developed and cured completely with a left SGB. Serial infrared thermograms were performed. The hypothermias on the affected side improved symmetrically by the end of the treatment.

• The Korean Journal of Pain
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• v.19 no.1
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• pp.115-118
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• 2006

Among the sympathetic blocks used to treat various symptoms and diseases, including sympathetic dysfunction in pain clinics, a stellate ganglion block (SGB) is one of the easiest to apply. However, it is difficult to evaluate the effects of SGB due to the subjective nature of patient-reported data. A 26-year-old female, who presented with symptoms of coldness and sweating on both hands, received SGB 25 times on each side over a 2-month period. The effects of SGB were followed up using a cold stress test with thermography. Although the symptoms appeared again after 6 months, the recovery rate of the palmar temperature after the cold stress test improved significantly and was maintained for 18 months.

• The Korean Journal of Pain
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• v.3 no.2
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• pp.131-138
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• 1990

Postherpetic neuralgia (PHN) causes intractable pain which disturbs sleep and daily life. Numerous drugs and treatment strategies have been introduced for the management of PHN. However, no single regimen has proved to be effective. I analysed 38 patients with PHN. Amitriptyline, a tricyclic antidepressant and chlorpromazine were most commonly prescribed. Stellate ganglion blocks for the head and neck pain and epidural blocks for the rest part of the body were most frequently given. Triamcinolone acetate was administered epidurally in most of the cases or by iontophoresis on the affected skin area in two cases. Complications were related to the technique of the nerve block and the side effects of drugs administered. Repeated nerve blocks with tricyclic antidepressant and steroid therapy were thought to be the most effective for the treatment of postherpetic pain.

• The Korean Journal of Pain
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• v.14 no.2
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• pp.231-233
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• 2001

Atrophic rhinitis is characterized by mucosal atrophy, bony absorption, persistent fetid odor and resistance to medical and surgical treatment. Stellate ganglion block (SGB) can be used as a therapeutic modality by improving the regional blood flow through sympathetic blockade. We present a case of a 57 year-old male patient who had been treated unsuccessully for atrophic rhinitis for several years by surgical and conservative measures. The patient presented at our pain clinic with shoulder pain and received stellate ganglion block once or twice a week. He received more than 75 SGBs in addition to the routine conservative treatment for atrophic rhinitis. As the number of blocks performed increased, the patient demonstrated subjective symptom relief. We measured regional mucosal blood flow using a laser doppler flowmeter after the 28th, 63rd and 75th blocks. Nasal mucosal blood flow was improved by 4.9%, 28.8% and 36.3% respectively. We also were able to observe the recovery of mucosal atrophy to an almost normal level by nasal endoscopy. The patient is currently free of symptoms and is being followed up on an outpatient bases.

• The Korean Journal of Pain
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• v.11 no.2
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• pp.346-349
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• 1998

The technique of the stellate ganglion block is widely used as it is relatively simple and safe. But it can cause severe complications because there are major blood vessels and nerves around the stellate ganglion. We practiced CPR because of the respiratory failure caused by severe hematoma in the neck following the stellate ganglion block. A 46-year-old male patient admitted to ENT department because of the both sudden sensorineural hearing loss that happened after URI. He was referred to Pain Clinic for further evaluation and treatment. We decided to block the stellate ganglion. We injected 6ml of 0.5% mepivacaine on both sides of the stellate ganglion. There were no blood aspiration and abnormal vital signs during the 30 minute observation, either. Three hours after he went to the private room, he had pain and edema in his neck, but no respiratory defficulty. But later, respiratory failure was suddenly followed. So we practiced CPR. We confirmed severe hematomas in the neck through CT scanning. Hematomas is removed and the ruptured blood vessels which is supposed to be muscular branch of vertebral artery is ligated under general anesthesia. The patient was discharged from hospital after the treatment of pneumonia and duodenal ulcer as complications. We recommand you to compress the block site more than five minutes and not to prick with the needle several times at one point to prevent the formation of hematomas.

• The Korean Journal of Pain
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• v.8 no.1
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• pp.78-81
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• 1995

We evaluated the effects of the stellate ganglion block(SGB) on the palmar hyperhidrosis. Ten patients of the palmar hyperhidrosis were taken right and left SGBs, 15 times on each side, total of 30 times, with 1% mepivacaine HCl 5 ml, with no discrimination on sex and age. Although there was a little decrease in the frequency of perspirations on 2 patients after the 15th block, no difference was noted after the overall 30th block at them. None of all 10 patients was satisfied symptomatically and no evidence of decreasing perspiration was found. Conclusively it seems that SGB with 1% mepivacaine HCl 5 ml is not an adequate therapy on the palmar hyperhidrosis even though it diminishes perspiration transiently.

• The Korean Journal of Pain
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• v.8 no.1
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• pp.124-126
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• 1995

Atopic allergy implies a familial tendency to manifest alone or in combination such as asthma, rhinitis, urticaria and atopic dermatitis. The patient with atopic dermatitis shows a variety of humoral and cell-mediated immune dysfunction, including an elevation of serum IgE level, multiple positive immediate skin tests to a variety of antigen. A 30 year old female patient suffering from an atopic dermatitis on face, has been administered a stellate ganglion block(SGB) with a 1% mepivacaine 5cc. She complained of bronchial hyperresponsivness such as cough, soreness, and inspiration difficulty for 5 days following the treatment, so we have reduced 1% mepivacaine dose from 5cc to 3cc. She had no complain of bronchial hyperresponsivenss and the lesion of atopic dermatitis was improved. From our result we conclude that SGB appears to be a good choice for the treatment of the atopic dermatitis and only 1% mepivacaine 3cc is possible in complete SGB.

• The Korean Journal of Pain
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• v.12 no.1
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• pp.140-143
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• 1999

Ramsay-Hunt syndrome is a related but more serious disorder caused by herpes zoster viral infection of the geniculate ganglion. It is characterized by unilateral painful vesicular rash of the uvula, palate, auricle, ear canal, and postauricular area, but it can extend into the facial tissues as well. Paralysis of the facial nerve is often seen, and there can be disequilibrium and hearing problems also. We experienced continuous cervical epidural block (CCEB) with intermittent stellate ganglion block is effective in Ramsay-Hunt syndrome. CCEB should be considered to the treatment of choice in Ramsay-Hunt syndrome.