Avoiding intravascular injection during ultrasound‐guided stellate ganglion block

Nix, Catherine; Harmon, Dominic

doi:10.1111/j.1365-2044.2010.06589.x

Cited by 7 publications

(4 citation statements)

References 2 publications

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“…The choice of puncture approach under ultrasound guidance is thus particularly important. There have been different reports regarding ultrasound-guided SGB through lateral approaches, including via the C7 transverse process and the C6 transverse process ( 3 , 4 ). Because the anterior tubercle of the C6 transverse process is long ( 5 ), the gap between the anterior tubercle and the internal jugular vein is narrow (<5 mm), and this affects the needle entry.…”

Section: Discussionmentioning

confidence: 99%

“…Ding et al ( 2 ) reported that ultrasound-guided SGB is more accurate than blind exploration. However, there are differing reports on ultrasound-guided SGB through lateral approaches, including blocking at the 7th cervical vertebra (C7) transverse process and at the 6th cervical vertebra (C6) transverse process ( 3 , 4 ). There are few comparative studies regarding puncturing at the C6 and C7 levels.…”

Section: Introductionmentioning

confidence: 99%

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Effects of Stellate Ganglion Block Through Different Approaches Under Guidance of Ultrasound

Shan

Chen

et al. 2022

Front. Surg.

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ObjectiveThis study aimed to investigate the effects of stellate ganglion block (SGB) through different approaches under guidance of ultrasound.MethodsA total of 130 patients undergoing SGB in our hospital between February 2019 and February 2020 were enrolled as the research subjects. According to the random number table method, these subjects were divided into two groups: a modified 6th cervical vertebra (C6) group (n = 65) and a 7th cervical vertebra (C7) group (n = 65). Under the guidance of ultrasound, the subjects in the modified C6 group were punctured at the level of the C6 transverse process, and the subjects in the C7 group were punctured at the level of the C7 transverse process. The operation duration, number of puncture angle adjustments, block effects, and adverse reactions for SGB were compared between the two groups.ResultsThe modified C6 group showed shorter SGB operation duration and a lower number of puncture angle adjustments than the C7 group, and the differences were statistically significant (P < 0.05). Horner Syndrome occurred in both groups after SGB. The incidence of adverse reactions in the modified C6 group was 4.62%, comprising 1 case of hoarseness and 2 cases of slowed pulse, while that in the C7 group was 6.15%, with 1 case of hoarseness and 3 cases of slowed pulse; the difference between the two groups was not statistically significant (P > 0.05).ConclusionThe operation duration for modified SGB guided by ultrasound puncturing at the C6 transverse process is shorter and requires fewer puncture angle adjustments than puncturing at the C7 transverse process; however, there is no significant difference between the incidence of adverse reactions or the blocking effects of the two methods.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effects of Stellate Ganglion Block Through Different Approaches Under Guidance of Ultrasound

Shan

Chen

et al. 2022

Front. Surg.

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“…In another case, cardiac arrest occurred during ultrasound-guided SGB. It was believed to be due to an injection of local anesthetic into the vertebral or inferior thyroid artery (43,44). Again, the patient was stabilized and discharged from the hospital the next day (44).…”

Section: Discussionmentioning

confidence: 99%

Safety and Comparative Efficacy of Ultrasound-Guided vs. Fluoroscopically- Guided Stellate Ganglion Block: A Retrospective Cohort Analysis and Focused Review of Literature

Le-Short

2017

PMCR

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Background: Stellate ganglion blocks (SGBs) are a valuable diagnostic and therapeutic tool for sympathetically mediated pain syndromes. There are many different techniques used to achieve an effective blockade, but there is limited literature comparing the safety and effi cacy of them. Objectives: We aim to evaluate the incidence of complications and the change in numerical rating scale (NRS) pain scores of 4 groups using varied image-guided techniques: fluoroscopy, ultrasound, fluoroscopy and ultrasound, and no image guidance. Study Design: This is a retrospective cohort study and focused literature review. Setting: A university hospital outpatient pain clinic. Methods: A chart review of all SGBs performed at our institution from September 2010 to August 2014 was performed. Data were collected regarding the patients’ age, gender, indication for the procedure, NRS score at one to 3 months and 3 – 6 months, type of image guidance used, and occurrence of a procedure-related complication. A literature review was performed on PubMed in January 2017 using the following search terms: stellate ganglion block and ultrasound, fl uoroscopy, safety, and effi cacy; the search was made using the English language and human subject fi lters, yielding 92 results. Results: No complications occurred in the ultrasound group (n = 19), fl uoroscopy and ultrasound group (n = 10), and no image guidance group (n = 2). Two complications occurred in the fl uoroscopy group (n = 105; 1.9%). There were no statistically signifi cant differences between the groups in terms of complications (P = 1), change in pain during the one to 3 month time-frame (P = 0.157), or change in pain between the 3 – 6 month time-frame (P = 0.484). Limitations: The retrospective study design with a small sample size could prove to be a limitation. Conclusions: No statistically significant difference was detectable between fl uoroscopy, ultrasound, fl uoroscopy and ultrasound, and no image guidance in terms of safety and effi cacy. With this in mind, we cannot make any defi nitive recommendations about which technique should be used; rather, this decision should be based on clinician preference and clinical scenario. IRB Approval: The research has been approved by the Institutional Review Board (PA14-0706). Key words: Stellate ganglion block, techniques, fl uoroscopy, ultrasound, sympathetically mediated pain, safety, complications, effi cacy

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“…Therefore, there was an opinion that the physician may have injected local anesthetic into the inferior thyroid artery rather the vertebral artery. [ 4 ] We report the ultrasound imaging findings of an atypical course of a left vertebral artery detected during a prescan before performing SGB.…”

Section: Introductionmentioning

confidence: 99%

Atypical course of vertebral artery identified by ultrasound prescan before performing a stellate ganglion block

Lee

2022

J Med Ultrasound

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Ultrasound provides direct visualization of blood vessels and soft tissues around the sympathetic chain and potentially minimizes injury to these critical anatomic structures when performing stellate ganglion block (SGB). We report an atypical left vertebral artery course detected during an ultrasound prescan before performing a SGB. The left vertebral and inferior thyroid arteries were identified on the longus colli muscle's ventral surface at the C6 level. This report was the first to demonstrate ultrasound images of a vulnerable vertebral artery to intravascular injection. The study emphasized the importance of identifying the sonoanatomy before performing procedures involving the anterior cervical vertebrae.

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Avoiding intravascular injection during ultrasound‐guided stellate ganglion block

Cited by 7 publications

References 2 publications

Effects of Stellate Ganglion Block Through Different Approaches Under Guidance of Ultrasound

Effects of Stellate Ganglion Block Through Different Approaches Under Guidance of Ultrasound

Safety and Comparative Efficacy of Ultrasound-Guided vs. Fluoroscopically- Guided Stellate Ganglion Block: A Retrospective Cohort Analysis and Focused Review of Literature

Atypical course of vertebral artery identified by ultrasound prescan before performing a stellate ganglion block

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