Journal of Yeungnam Medical Science

Original Article

Comparison of ultrasound-guided stellate ganglion block at 6th and 7th cervical vertebrae using the lateral paracarotid out-of-plane approach for sympathetic blockade in the upper extremity: Jongyoon Baek, Bum Soo Kim, Hwarim Yu, Hyuckgoo Kim, Chaeseok Lim, Sun Ok Song; Yeungnam Univ J Med. 2018;35(2):199-204. Published online December 31, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.2.199

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Background
The authors have performed ultrasound-guided stellate ganglion block (SGB) in our clinic using a lateral paracarotid approach at the level of the 6th cervical vertebra (C6). Although SGB at C6 is a convenient and safe method, there are ongoing concerns about the weak effect of sympathetic blockade in the ipsilateral upper extremity. Therefore, ultrasound-guided SGB was attempted using a lateral paracarotid approach at the level of the 7th cervical vertebra (C7). This prospective study aimed to compare changes in skin temperature after SGB was performed at C6 and C7, and to introduce a lateral paracarotid approach for SGB.
Methods
Thirty patients underwent SGB twice: once at C6 and once at C7. For every SGB, the skin temperature of the patient’s hypothenar area was measured for 15 min at 1-min intervals. Skin temperatures before and after SGB and side effects were compared between C6 and C7 groups.
Results
The temperature of the upper extremity increased after SGB was performed at C6 and C7. There were significant differences between mean pre-SGB and the largest increases in post-SGB temperatures (0.50±0.38℃ and 1.41±0.68℃ at C6 and C7, respectively; p<0.05). Significantly increased post-SGB temperatures (difference >1℃) were found in 5/30 (16.7%) and 24/30 (80%) cases for C6 and C7, respectively (p<0.05). There were no significant differences in side effects between SGB performed at C6 or C7 (p>0.05).
Conclusion
The lateral paracarotid approach using out-of-plane needle insertion for ultrasound-guided SGB performed at C7 was feasible and more effective at elevating skin temperature in the upper extremity than SGB at C6.

Citations

Citations to this article as recorded by

The usefulness of stellate ganglion block with ultrasound-guided lateral paracarotid approach in ventricular arrhythmias: A case series
Hansung Ryu, Hyuckgoo Kim
Saudi Journal of Anaesthesia.2024; 18(2): 276. CrossRef
Establishment of ultrasound-guided stellate ganglion block in rats
Shi-zhu Lin, Lu Chen, Yi-jie Tang, Cheng-jie Zheng, Peng Ke, Meng-nan Chen, Hai-xing Wu, Yu Chen, Liang-cheng Qiu, Xiao-dan Wu, Kai Zeng
Frontiers in Neuroscience.2023;[Epub] CrossRef
Magnetic resonance imaging validation of medial transthyroid ultrasound‐guided stellate ganglion block: A pilot study
Boo Young Chung, Christian Holfelder, Robert E. Feldmann, Dieter Kleinboehl, Raoul C. Raum, Justus Benrath
Pain Practice.2022; 22(3): 329. CrossRef
Prolonged blockade of the cervical sympathetic nerve by stellate ganglion block accelerates therapeutic efficacy in trigeminal neuropathy
Kazune Kawabata, Teppei Sago, Tsuneto Oowatari, Shunji Shiiba
Journal of Oral Science.2022; 64(1): 6. CrossRef
Comment on an Article by Aleanakian et al. Titled “Effectiveness, Safety, and Predictive Potential in Ultrasound‐Guided Stellate Ganglion Blockades (SGB) for the Treatment of Sympathetically Maintained Pain”
Pratibha Singh, Anil Agarwal, Chetna Shamshery
Pain Practice.2021; 21(5): 602. CrossRef

Case Reports

Use of stellate ganglion block for treatment of recurrent syncope followed by chest pain: Young-ung Kim, Yong-joon Shin, Young Woo Cho; Yeungnam Univ J Med. 2018;35(1):104-108. Published online June 30, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.1.104

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Abstract PDF: Syncope is defined as a transient loss of consciousness and postural tone, characterized by rapid onset, short duration, and spontaneous recovery. Stellate ganglion block (SGB) is a nerve block method that is used for treatment of neuropathic pain in the head, neck and upper extremities, especially trigeminal neuralgia, postherpetic neuralgia and complex regional pain syndrome. SGB can modulate and stabilize the sympathetic nervous system, which prevents it from overexcitation and improves symptoms of syncope. The authors report a patient who was treated for pain and edema of both upper extremities with SGB, then showed improvement in recurrent syncope followed by chest pain and overall quality of life.

Prolonged blepharoptosis following repeated stellate ganglion block in a patient with brachial plexopathy after thoracoscopic surgery.: Kangil Kim, Sang Hyun Lee, Eun Hui Seo, Young Woo Cho; Yeungnam Univ J Med. 2014;31(2):135-138. Published online December 31, 2014; DOI: https://doi.org/10.12701/yujm.2014.31.2.135

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Abstract PDF: A 34-year-old female was suffered from pain and numbness of right arm for 2 months after undergoing a thoracoscopic procedure for a posterior mediastinal mass that was diagnosed as neurilemmoma. The patient was diagnosed as a complex regional pain syndrome type 2 with brachial plexopathy developed during thoracoscopic excision of posterior mediastinal mass, and stellate ganglion block (SGB) with 0.2% ropivacaine 10 mL was performed every 3-4 days. The patient revealed slightly prolonged blepharoptosis as Horner syndrome accompanied after every SGB and recovered. However, following the 23rd SGB, the blepharoptosis persisted and patient was recovered spontaneously from blepharoptosis after about 12 months. The possibility that the persistent blepharoptosis might be caused by brachial plexopathy related to patient's pathology or surgical manipulation and/or repeated SGB. If Horner syndrome occurs, its etiology should be assessed, and it would be necessary to explain and to assure the patient the possibility of recovery spontaneously from the complication within a year, without any sequelae.

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