A854 Anterior Psoas Sheath Identification for Lumbar Sympathetic Block

Sprague, Robert S.; Ramamurthy, Somayaji

doi:10.1097/00000542-199009001-00852

Cited by 3 publications

(5 citation statements)

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“…The LSGB is traditionally performed under the fluoroscopy. The classical three-needle technique and the lateral technique have been widely used in clinical practice (4,16,17). In the current study, we used the lateral technique.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound-Guided Lumbar Sympathetic Ganglion Blockade Using Shamrock Method: A Prospective Case Series

Ma¹,

Wang²,

Bao³

et al. 2016

J Anesth Perioper Med

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Background: Lumbar sympathetic ganglion blockade (LSGB) is traditionally performed using x-ray in either the fluoroscopy suite, or CT in the radiology department. This case series evaluated the feasibility of using the ' Shamrock method'to perform LSGB under ultrasound guidance in patients. Methods: A total of 16 patients with postherpetic neuralgia received a real-time LS-GB under the guidance of Shamrock ultra-sonogram for pain management. The blocks were performed using the in-plane needle insertion. Ultrasound visibility of the lumbar paravertebral structures was assessed in real time during the scout scan. Sympathetic block after LSGB was considered successful when changes in ipsilateral skin temperature between preblock and postblock were >2℃. Results: The lumbar paravertebral region was successfully visualized in all patients with a median ultrasound visibility score of 15 (range, 8-18). The skin temperature of the big toe before LSGB was significantly lower than that 20 minutes after LSGB. Additionally, the changes in skin temperature between preblock and postblock were >2℃ in 15 (93.8%) of 16 patients. Conclusions: Ultrasound-guided LSGB can be reliably accomplished using the Shamrock method.

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Section: Discussionmentioning

confidence: 99%

Ultrasound-Guided Lumbar Sympathetic Ganglion Blockade Using Shamrock Method: A Prospective Case Series

Ma¹,

Wang²,

Bao³

et al. 2016

J Anesth Perioper Med

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“…Under fluoroscopic guidance, the technique has been demonstrated to be easy to perform. 60 Computerized tomography (CT), 61 MRI, 62 and ultrasound based techniques have also been described and their reliability demonstrated. 63 However, since CT and MRI are time-consuming and less suitable for daily practice, fluoroscopy remains the method of choice.…”

Section: Ganglion Stellatum (Stellate Ganglion) Blockmentioning

confidence: 99%

“…Unlike the SGBs, image‐guided techniques are mandatory. Under fluoroscopic guidance, the technique has been demonstrated to be easy to perform 60 . Computerized tomography (CT), 61 MRI, 62 and ultrasound based techniques have also been described and their reliability demonstrated 63 .…”

mentioning

confidence: 99%

16. Complex Regional Pain Syndrome

et al. 2010

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Complex regional pain syndrome (CRPS), formerly known as reflex sympathetic dystrophy is a pain syndrome with an unclear pathophysiology and unpredictable clinical course. The disease is often therapy resistant, the natural course not always favorable. The diagnosis of CRPS is based on signs and symptoms derived from medical history and physical examination. Pharmacological pain management and physical rehabilitation of limb function are the main pillars of therapy and should be started as early as possible. If, however, there is no improvement of limb function and persistent severe pain, interventional pain management techniques may be considered. Intravenous regional blocks with guanethidine did not prove superior to placebo but frequent side effects occurred.Therefore this technique receives a negative recommendation (2 A–). Sympathetic block is the interventional treatment of first choice and has a 2 B+ rating. Ganglion stellatum (stellate ganglion) block with repeated local anesthetic injections or by radiofrequency denervation after positive diagnostic block is documented in prospective and retrospective trials in patients suffering from upper limb CRPS. Lumbar sympathetic blocks can be performed with repeated local anesthetic injections. For a more prolonged lumbar sympathetic block radiofrequency treatment is preferred over phenol neurolysis because effects are comparable whereas the risk for side effects is lower (2 B+). For patients suffering from CRPS refractory to conventional treatment and sympathetic blocks, plexus brachialis block or continuous epidural infusion analgesia coupled with exercise therapy may be tried (2 C+). Spinal cord stimulation is recommended if other treatments fail to improve pain and dysfunction (2 B+). Alternatively peripheral nerve stimulation can be considered, preferentially in study conditions (2 C+).

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“…In the cervicothoracic (stellate ganglion) block, acute potentially life-threatening complications may occur including seizures, spinal block, hypotension, or pneumothorax (106)(107)(108)(109)(110)(111)(112)(113). Additional complications include block or injury to the recurrent laryngeal nerve, phrenic nerve, sympathetic trunk, apex of the lung, or brachial plexus.…”

Section: Sympathetic Nerve Blocksmentioning

confidence: 99%

“…In the lumbar sympathetic block, potential complications include intravascular injections, intradural injections with spinal anesthesia or postural headaches, hypotension, lumbar plexus block, renal puncture, or genitofemoral neuralgia (107,112,113). Other risks include injury to the spleen, gut, liver, and injection of large volumes of local anesthetic into the aorta or inferior vena cava.…”

Section: Sympathetic Nerve Blocksmentioning

confidence: 99%

Prevention and Management of Complications Resulting from Common Spinal Injections

Windsor

Storm²,

Sugar³

2003

Pain Phys

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When spinal injections are performed, a needle is placed in or around the spine making the risk of complications unavoidable. Spinal structures or adjacent organs are at risk for direct needle trauma, infection, hematoma, hemorrhage, nerve dam-age, stroke, allergic reaction, or spinal anesthesia with cardiorespiratory arrest. As a result, physician knowledge and patient preparation and monitoring are critical in maximizing patient safety during the procedure being performed. This review de-scribes complications that may result from commonly performed spinal injections and their treatment.

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A854 Anterior Psoas Sheath Identification for Lumbar Sympathetic Block

Cited by 3 publications

References 0 publications

Ultrasound-Guided Lumbar Sympathetic Ganglion Blockade Using Shamrock Method: A Prospective Case Series

Ultrasound-Guided Lumbar Sympathetic Ganglion Blockade Using Shamrock Method: A Prospective Case Series

16. Complex Regional Pain Syndrome

Prevention and Management of Complications Resulting from Common Spinal Injections

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