• The Korean Journal of Pain
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• 제11권1호
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• pp.109-112
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• 1998

The sympathetic nervous system has been implicated as an important factor contributing to causalgia. Basis on reports of presence of opioid receptors in sympathetic autonomic ganglia, including human stellate ganglion, we administered morphine in stellate ganglion block for a patient with causalgia. The patient suffering from brachial plexus injury treated with stellate ganglion block in conjunction with physical therapy. Stellate ganglion block was performed in a paratracheal approach by injection of 1% lidocaine, or 0.25% bupivacaine 8 ml, with morpine 1 mg. Patient's symptoms were dramatically improved after 13 stellate ganglion blocks.

• The Korean Journal of Pain
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• 제8권2호
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• pp.312-318
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• 1995

Stellate ganglion block is extensively performed in pain closing to treat a diversity of diseases. Stellate ganglion phenol neurolysis, however, has not been not popular because of risk and complications such as: permanent horner's syndrome, hoarseness, pneumothorax and intravascular or intraspinal injection. But Racz recently performed stellate ganglion phenol neurolysis successfully, under fluoroscopic guide, minus significant complication. Three patients were recently treated at our pain clinic by repeated stellate ganglion block with local anesthetics. Patients showed immediate signs of improvement but prolonged pain relief was not achieved. Therefore we reported to performing stellate ganglion phenol neurolysis following Racz's technique. We successfully treated: two cases of reflex sympathetic dystrophy of the upper extremity, and a case of postherpetic neuralgia of jaw, neck and upper chest wall, by stellate ganglion phenol neurolysis, devoid of any significant complications.

• The Korean Journal of Pain
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• 제10권2호
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• pp.278-280
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• 1997

Stellate ganglion block has been used to treat diseases such as peripheral vascular disease, sympathetic dystrophy, and various pain syndromes involving the head or arm. Raynaud's disease is a syndrome manifested by attacks of pallor, cyanosis, numbness and pain of the digits in response to cold or emotional change. I report one case who was given Stellate ganglion block using 18G teflon Catheter(4.5 cm in length) for Raynaud's disease. Continuous stellate ganglion block is more convinient to inpatient than repeated needle punctures and may reduce major complications and more useful to patient who needs continuous sympathetic block about one week duration.

• The Korean Journal of Pain
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• 제9권1호
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• pp.114-119
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• 1996

Buerger's disease is a nonatherosclerogic occlusive inflammatory disease of medium and small arteries, and veins, of unknown cause. It occurs predominantly in young males who are habitual tabacco users. These patients often complain of painful ulcerations of their digits. The care of this disease is very difficult when the treatment is delayed. Consequently, early treatments are most important to patients with Buerger's disease. This disease can be treated with sympathetic block such as stellate ganglion block for upper extremities and lumbar epidural block, and lumbar sympathetic block for lower extremities. Intravascular regional sympathetic block can be another method of treatment. However, discontinuation of smoking is the most basic and essential treatment for Buerger's disease. We treated 43 Buerger's disease patients with stellate ganglion block and laser therapy. The treatment was not effective for three patients who definitely required amputation.

• Journal of Dental Anesthesia and Pain Medicine
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• 제16권3호
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• pp.159-163
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• 2016

Orofacial pain is a common complaint of patients that causes distress and compromises the quality of life. It has many etiologies including trauma, interventional procedures, nerve injury, varicella-zoster (shingles), tumor, and vascular and idiopathic factors. It has been demonstrated that the sympathetic nervous system is usually involved in various orofacial pain disorders such as postherpetic neuralgia, complex regional pain syndromes, and atypical facial pain. The stellate sympathetic ganglion innervates the head, neck, and upper extremity. In this review article, the effect of stellate ganglion block and its mechanism of action in orofacial pain disorders are discussed.

• The Korean Journal of Pain
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• 제14권2호
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• pp.239-244
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• 2001

Stellate ganglion block (SGB) is a frequently used sympathetic block utilized to diagnose or treat various painful conditions of the cervical regions and the upper extremities. Additionally, RadioFrequency (RF) lesions of the stellate ganglion can be useful in managing sympathetically-maintained pain. Two patients were suffering from pain in the face, neck and the upper extremities were treated with stellate ganglion block. In spite of repeated blocks, the degree and duration of pain did not decrease. However, after performing radiofrequency thermocoagulation of the stellate ganglion under fluroscopy, followed by thermography on the process of treatment with RF stellate ganglion neurolysis, the patients' pain levels were alleviated after the RF lesions of stellate ganglion and the procedure also increased the temperature at the upper extremity on thermogarphy. Additionally, the patients did not complain of any remarkable complications following this procedure.

• The Korean Journal of Pain
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• 제7권2호
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• pp.162-169
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• 1994

Blockade of cervicothoracic sympathetic ganglion (stellate ganglion controls pain on face, head, neck, shoulder, upper limbs, and upper chest, including their viscera and sympathetically maintained pain. This procedure also increases blood flow to the above areas and relieves hyperreactivity of sympathetic nervous system. Clinically, repeated stellate ganglion blocks with local anesthetic agent may become difficult with complications such as accidental intravascular or subdural injection, recurrent laryngeal nerve or bracheal plexus paralysis, pneumothorax and edema on injection site. Therefore, at times long-term cervicothoracic ganglion block with neurolytics is necessitated but its applications are prohibited by the critical structures surrounding ganglion. There are also few reports of neurolytic stellate ganglion block. This study was performed to observe the complications, gross changes of surrounding structures, and microscopic findings of ganglion cells after neurolytic block and to certify the possibility of clinical use of neruolytic stellate ganglion block. The unilateral superior cervical sympathetic ganglion of rabbit was blocked with absolute ethyl alcohol 0.4 ml at the level of cricoid cartilage. Normal ganglion was used as a control and 5 animals were sacrificed at each intervals of 7, 15 and 50 days after block. The results were as follows; 1) All experimental animals showed no specific changes of behavior, motor function. No necrotic tissues were present in the block area during the observation period. There were some gross scar tissues along the fascia of muscles surrounding the needle injection site, but gross atrophy of muscles or injured major vessels were not found. 2) Microscopically, structures of normal ganglion of rabbit were very similar to those of humans. Seven days after absolute ethyl achohol injection there were marked edema of ganglion cells and nuclei with irregular nuclear membrane. Some of the ganglion cells lost their nuclei and showed degenerative changes. Fifteen days after block, cell edema were decreased and loss of the Nissl's body was prominant. The ganglion cell structures looked close to normal but the cytoplasm and nucleus were generally contracted 50 days after block. These results suggest absolute ethyl alcohol injection on cervical sympathetic ganglion with above method mainly blocks pre- and post-synaptic fibers and the long-term neurolytic blockade of this ganglion may be possible in rabbits.

• The Korean Journal of Pain
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• 제8권1호
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• pp.60-64
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• 1995

Stellate ganglion block is a selective sympathetic blockade affecting the head and neck, and the upper extemity. It is an important method which has been used most frequently in neuro-pain clinic due to its wide range of indications. The authors attermpted to define the minimal volume of local anesthetic which need for successful stellate ganglion block by using 1% mepivacaine HCl mixed with dye. In 40 heathy volunteers, two different volumes, 3 ml in the group 1 (n=20) and 4 ml in the group 2 (n=20), were injected by an anterior paratracheal technique at the sixth cervical vertebral level. We compared the degree in sympathetic blockade by clinical sings and symptoms and also checked the spread range of dye by plain X-ray. With seven criteria for an effective block. mean score was 5.7 in group 2, while 3.4 in group 1. These results suggest that 4 ml of local anesthetic are adequate for a successful stellate ganglion block.

• The Korean Journal of Pain
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• 제6권2호
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• pp.255-257
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• 1993

Shoulder Hand Syndrome is used to describe painful disabilities of the upper extremity due to disturbances of sympathetic nerve supply. A 72 year old male developed hemiplegia on left side on the 5 days after open heart surgery of aortic valve replacement. Three months later, the patient complained of severe pain in the left upper extremity involving shoulder. The left hand showed swelling and flaccid paralysis. Thereafter the left stellate garglion block with 10 ml of l% lidocaine produced prompt pain relief. Thereafter the patient received 94 stellate ganglion block during 7 months which produced permanent remission of pain throughout a 1 year follow period. We recommand sympathetic block for of Shoulder Hand Syndrome following hemiplegia.

• The Korean Journal of Pain
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• 제7권2호
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• pp.258-262
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• 1994

Thermography is a non-invasive, comfortable, diagnostic technique to monitor successful sympathetic block. We observed abnormal thermal distribution during disease state and then followed with thermography on the process of treatment with stellate ganglion block.