• The Korean Journal of Pain
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• 제7권1호
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• pp.84-87
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• 1994

Retrospective analysis, of 1,734 patients treated for nerve block from October 1991 to March 1994. Largest percentage of patients were in the 50 year old range, with a distribution of 44.9% male and 55.1% female. Treatments were for ailments of: Low Back Pain 17.3%, Multiple Contusion 10.5%, and Cancer 10%. Most common nerve block was epidural block 38.6%, followed by stellate ganglion block 38.4%, intercostal block 5.4%, and suprascapular nerve block 5.2%. Nerve block under fluorscopic guide were as follows: facet joint block 34.1%, lumbar sympathetic ganglion block 13.6%, and celiac plexus block 12.9%.

• The Korean Journal of Pain
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• 제13권2호
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• pp.191-195
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• 2000

Background: Vascular occlusive event is one of the etiologies of sudden sensorineural hearing loss (SNHL). Stellate ganglion block (SGB) induces dramatic and intense vasodilatation in head and neck. Based on this principle, SGB has used as one of the treatment modalities in SNHL. This study was performed to evaluate immediate response of SGB on pure tone audiogram (PTA) in SNHL. Methods: Forty patients were studied. Each patient received daily ipsilateral SGB in paratracheal approach using 0.2% bupivacaine for 2 weeks. On first, third, and fifth day of treatment, we checked their PTA twice 1 hour before (Pre-PTA) and after (Post-PTA) SGB. Pre- and Post-PTA were compared. Several factors were analyzed as a prognostic factor of therapeutic results. Results: Eleven of 40 patients revealed decreased PTA after SGB. Degree of decreased PTA were insignificant ($2.5{\pm}1.6$ dB). Initial and final PTA results was $76.2{\pm}22.5$ and $49.8{\pm}28.3$ dB, respectively. Thirty-one of 40 patients were improved their PTA over 10 dB. The recovery was mainly influenced by the severity of initial hearing loss (P<0.001) and slightly by age (P<0.05). However, the change of PTA after SGB, time interval to receive SGB, sex, site, and number of SGB were not correlated to therapeutic outcome. Conclusions: These results suggest that vasodilatation by SGB has no immediate improvement in SNHL. Therefore, we question whether SGB is beneficial to all patients with SNHL as a therapeutic modality.

• The Korean Journal of Pain
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• 제13권2호
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• pp.182-186
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• 2000

Background: Ropivacaine is a new amide local anesthetics, having therapeutic properties similar to those of bupivacaine but less cardiovascular toxicity and motor blockade. The aim of this study was to evaluate the effects of ropivacaine used in stellate ganglion block (SGB) compared with those of lidocaine or bupivacaine. Methods: This prospective and crossover study performed in twenty patients with sudden sensory neural hearing loss. All patients received three times SGB, in the paratracheal approach using 8 ml of 1% lidocaine, 0.2% bupivacaine, and 0.2% ropivacaine respectively without any orders. Onset time and action duration of Horner's syndrome were observed after each SGB. Results: Onset time of ropivacaine was the middle of the three agents; earlier lidocaine and slower bupivacaine. Lidocaine ($3.0{\pm}1.9$ min), bupivacaine ($4.1{\pm}2.9$ min) and ropivacaine ($3.3{\pm}1.3$ min). But there were no significant differences; Action duration of Horner's syndrome of ropivacaine (223.6?105.2 min) was longer than lidocaine ($134.6{\pm}77.3$ min) and shorter than bupivacaine ($241.2{\pm}115.8$ min). There were significant differences in the action duration of each local anesthetics (P<0.05). There was no critical side effects and temporary foreign body sensation was the most common side effect. Conclusions: We conclude that ropivacaine is a good alternative in SGB instead of lidocaine or bupivacaine. Ropivacaine is a long acting local anesthetic similar to those of bupivacaine with wide margin of safety. However, optimal concentration and volume of ropivacaine in SGB should be studied.

• The Korean Journal of Pain
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• 제19권1호
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• pp.68-71
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• 2006

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.

• The Korean Journal of Pain
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• 제19권2호
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• pp.202-206
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• 2006

Background: Stellate ganglion block (SGB) might be associated with changes in the blood pressure (BP) and heart rate (HR). The heart rate variability (HRV) shows the balance state between sympathetic and parasympathetic activities of the heart. The changes in these parameters of the HRV were studied to evaluate the possible mechanism of SGB in changing the BP. Methods: SGB was performed on 26 patients, using a paratracheal technique at the C6 level, and 8 ml of 1% mepivacaine injected. The success was confirmed by check the Horner's syndrome. The BP, HR and HRV were measured before and 5, 15, 30, 45 and 60 minutes after the SGB. Results: The increases in the BP from the baseline throughout the study period were statistically, but not clinically significant. The HR and LF/HF (low frequency/high frequency) ratio were increased at 5 and 45 min, respectively, after the administration of the SGB. In a comparison of left and right SGB, no significant differences were found in the BP, HR and HRV. A correlation analysis showed that an increased BP was significantly related with the changes in the LF/HF ratio and LF at 15 and 30 minutes, respectively, after the SGB. Dividing the patients into two groups; an increased BP greater and less than 20% of that at the baseline INC and NOT groups, respectively, hoarseness occurred more often in the INC group (P = 0.02). Conclusions: It was concluded that SGB itself does not clinically increase the BP and HR in normal hemodynamic patients. However, the loss of balance between the sympathetic and parasympathetic nerve system, attenuation of the baroreceptor reflex and hoarseness are minor causes of the increase in the BP following SGB; therefore, further studies will be required.

• The Korean Journal of Pain
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• 제19권2호
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• pp.197-201
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• 2006

Background: There are cases in which shoulder pain persists long after shoulder joint surgery and this pain can not be reduced by intravenous patient controlled analgesia (IVPCA). Our purpose was to evaluate the effect of stellate ganglion block (SGB) on postoperative shoulder pain and also to investigate the effect of preventive SBG on complex regional pain syndrome (CRPS). Methods: Forty patients, who were evaluated to ASA class 1 and 2 and who were scheduled for shoulder joint surgery under general anesthesia, were randomly divided into 2 groups. The experimental group of patients (n = 20) received SGB with 0.5% mepivacaine 8 ml after induction of general anesthesia. The control group of patients (n = 20) received only general anesthesia. Their postoperative pain was assessed using the visual analog scale (VAS) at 30 min, 1, 2, 6, 12, 24 and 48 hours postoperatively. Whenever patients wanted supplemental analgesia, diclofenac sodium 75 mg was injected intramuscularly and the need for supplemental analgesia was recorded. Results: The experimental group of patients had significantly lower pain scores at 30 min, 1, 2 and 6 hours and also significantly lower analgesic requirement at 1, 2 and 6 hours. Conclusions: We found SGB was effective for controlling postoperative pain after shoulder joint surgery. Also, we could expect that SGB reduced the incidence of CRPS.

• The Korean Journal of Pain
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• 제8권1호
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• pp.65-73
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• 1995

1) 돌발성난청의 치료성적은 대조군, 성상신경절차 단군 각각 완전회복 28.6%, 18.5%, 부분회복은 6.1%, 7.4%, 경도회복은 16.3%, 25.9%로 성상신경절차단군이 예후가 나쁜 인자가 많았음에도 불구하고 두군사이에 유의한 차이가 없었다. 2) 회복예후는 두통이 수반될 때, 청력형이 농형일 때 예후가 불량하였고, 발증에서 치료시작까지의 기간이 빠를수록 좋았으며 특히 성상신경절차단을 2주 이내에 시행한 경우에는 반응이 없었던 예가 없었다.

• The Korean Journal of Pain
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• 제7권1호
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• pp.69-73
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• 1994

A 37 years old man who suffered from right facial palsy was treated successfully with the application of both magnetic resonance diagnostic analyser(MRA) and stellate Ganglion block(SGB). SGB is effective in treatment of facial palsy resulting from abolishing cerebral vascular spasm and increasing cerebral blood flow. Short daily period of exposure to appropriate MRA can also modulate the balance of autonomic nervous system that are responsible for sympathetic overflow resulting the edema and poor circulation on the course of the facial nerve. It was seemed that recovery of facial palsy by application of both MRA and SGB was faster than by SGB only.

• The Korean Journal of Pain
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• 제26권1호
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• pp.57-61
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• 2013

Background: Olfactory dysfunction, including anosmia and hyposmia is difficult to treat. Although the mechanism is not well known, stellate ganglion block (SGB) is used to treat olfactory dysfunction. There are no prior studies on the long-term effects of SGB on olfactory dysfunction. The purpose of this study was to evaluate the continuity of therapeutic effects and patient satisfaction with SGB treatment. Methods: This was a follow-up study carried out via a telephonic survey. The olfactory function of the patient was evaluated using a visual analog scale (VAS). We checked VAS three times: VAS-I (pre-treatment VAS), VAS-A (post-treatment VAS), and VAS-C (VAS at follow up telephone survey). We divided the subjects into 2 groups according to their responsiveness to SGB: the responsive (R group) and the unresponsive groups (UR group). Patient satisfaction was evaluated using a Likert scale. Results: Out of the 40 subjects, 37 responded to the telephone survey. In the UR group, there was difference in the olfactory function. However, in the R group, there were significant VAS differences; VAS-I was $9.6{\pm}0.7$, VAS-A was $5.1{\pm}4.2$, and VAS-C was $2.7{\pm}$2.7 (P < 0.05). On the Likert scale, patient satisfaction was as follows: grade 1, 17 patients (45.9%); grade 2, 6 patients (16.2%); grade 3, 6 patients (16.2%); and grade 4, 8 patients (21.6%). Conclusions: SGB is a safe, long-lasting, and effective therapeutic modality for olfactory dysfunction treatment.

• The Korean Journal of Pain
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• 제36권2호
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• pp.216-229
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• 2023

Background: The role of the sympathetic nervous system appears to be central in causing pain in complex regional pain syndrome (CRPS). The stellate ganglion block (SGB) using additives with local anesthetics is an established treatment modality. However, literature is sparse in support of selective benefits of different additives for SGB. Hence, the authors aimed to compare the efficacy and safety of clonidine with methylprednisolone as additives to ropivacaine in the SGB for treatment of CRPS. Methods: A prospective randomized single blinded study (the investigator blinded to the study groups) was conducted among patients with CRPS-I of the upper limb, aged 18-70 years with American Society of Anaesthesiologists physical status I-III. Clonidine (15 ㎍) and methylprednisolone (40 mg) were compared as additives to 0.25% ropivacaine (5 mL) for SGB. After medical treatment for two weeks, patients in each of the two groups were given seven ultrasound guided SGBs on alternate days. Results: There was no significant difference between the two groups with respect to visual analogue scale score, edema, or overall patient satisfaction. After 1.5 months follow-up, however, the group that received methylprednisolone had better improvement in range of motion. No significant side effects were seen with either drug. Conclusions: The use of additives, both methylprednisolone and clonidine, is safe and effective for the SGB in CRPS. The significantly better improvement in joint mobility with methylprednisolone suggests that it should be considered promising as an additive to local anaesthetics when joint mobility is the concern.