EN | UA
EN | UA

Help Support

Back

Evaluation of new approach to ultrasound guided stellate ganglion block

Evaluation of new approach to ultrasound guided stellate ganglion block Evaluation of new approach to ultrasound guided stellate ganglion block
Evaluation of new approach to ultrasound guided stellate ganglion block Evaluation of new approach to ultrasound guided stellate ganglion block

Ultrasound imaging is an ideal tool for stellate ganglion block (SGB) due to clarity, portability, lack of radiation, and low cost. 

See All

Key take away

This original research article deals with using the lateral approach at C 7 vertebral level helpful in complex regional pain syndrome of the upper limb in patients. The addition of steroid to the local anesthetic mixture sustained the effect in pain relief.

Background

Ultrasound imaging is an ideal tool for stellate ganglion block (SGB) due to clarity, portability, lack of radiation, and low cost. Ultrasound guided anterior approach requires the application of pressure to the anterior neck and is associated with more risk of injury to inferior thyroid artery, vertebral artery, and esophagus. The lateral approach does not interfere with nerve or vascular structures. Blockade at the C 6 vertebral level results in more successful sympathetic blockade of the head and neck with less sympathetic blockade of the upper extremity compared to sympathetic blockade at C 7 vertebral level, which produces successful sympathetic blockade of upper extremity. This is helpful in patients of complex regional pain syndrome of the upper limb. Hence, we conducted a study using the lateral approach at C 7 level.

Method

Ultrasound guided SGBs using lateral in-plane technique at C 7 level were given in 20 patients suffering from chronic pain patients of upper extremity, head, and neck using 4 ml of 0.25% bupivacaine and 1 ml of 40 mg triamcinolone. The patients were assessed for a numeric pain intensity score (NPIS), the rise in axillary temperature, the range of motion of joints of upper extremity, and resolution of edema at various time intervals up to 3 months. 

Result

NPIS showed a statistically significant decrease from baseline at 30 min, which was sustained till 3rd month. The rise in axillary temperature after the block was statistically significant, which was sustained till 2nd week. The edema score decreased significantly at all-time intervals (P ≤ 0.001). The restriction of motion in all joints of upper limb decreased from 13 to 3 patients.

Conclusion

There is a significant variation in the anatomy of stellate ganglion at the level of C 6 and C 7. Ultrasound guided lateral approach increases the efficacy of SGB by deposition of drug subfascially with real-time imaging.

Source:

Saudi J Anaesth. 2016 Apr-Jun;10(2):161-7

Article:

Evaluation of new approach to ultrasound guided stellate ganglion block

Authors:

Anju Ghai et al.

Comments (0)

You want to delete this comment? Please mention comment Invalid Text Content Text Content cannot me more than 1000 Something Went Wrong Cancel Confirm Confirm Delete Hide Replies View Replies View Replies en
Try: