Delayed severe airway obstruction due to hematoma following stellate ganglion block

Mishio, M; Matsumoto, Tsutomu; Okuda, Yasuhisa; Kitajima, Toshimitsu

doi:10.1016/s1098-7339(98)90038-4

Cited by 12 publications

(10 citation statements)

References 23 publications

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“…This technique involves directing the needle toward the bone and then withdrawing it while injecting the solution, which means that the needle tip is located in the longus colli muscle. However, the final position of the needle and the spread of the local anesthetic agent are unpredictable with the blind technique, which may result in unintended serious injections (vascular, subdural, or intrathecal) [14][15][16].…”

Section: Plos Onementioning

confidence: 99%

Bi-national survey of Korea and Japan related to the injection site for ultrasound-guided stellate ganglion blocks and anatomic comparisons using cadaver dissection

et al. 2020

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The aims of this study were to investigate the current clinical practice of ultrasound (US)guided stellate ganglion block (SGB) using a bi-national survey of Korea and Japan, and to clarify the anatomical relation of the cervical sympathetic trunk with the prevertebral fascia at the level of cervical vertebrae. The current clinical practice of US-guided SGB in Korea and Japan was investigated using an Internet survey, which received 206 (10.2%) replies from Korea and 97 (8.8%) replies from Japan. The survey questionnaire addressed the actual clinical practice for US-guided SGB, including where the tip of the injection needle is placed. Additionally, 16 half necks of 8 embalmed cadavers were used in an anatomical study. An inplane needle approach technique and administering 5 ml of local anesthetic were preferred in both countries. However, the type of local anesthetic differed, being lidocaine in Korea and mepivacaine in Japan. The final position of the needle tip also clearly differed in an US image, being predominantly positioned above the prevertebral fascia in Korea (39.3%) and under the prevertebral fascia in Japan (59.8%). In all of the anatomic dissections, the cervical sympathetic trunk was over the prevertebral fascia at the level of the sixth vertebra and under the prevertebral fascia at the level of the seventh vertebra. These results are expected to improve the knowledge on the current clinical practice and to suggest future studies.

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Section: Plos Onementioning

confidence: 99%

Bi-national survey of Korea and Japan related to the injection site for ultrasound-guided stellate ganglion blocks and anatomic comparisons using cadaver dissection

et al. 2020

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“…A total of 16 cases of VA-related complications in the percutaneous nerve block procedures was reported in the literature, which is summarized in Table 2 (63)(64)(65)(66)(67)(68)(69)(70)(71)(72)(73)(74)(75)(76). The complications occurred following stellate ganglion block procedures in the majority of cases.…”

Section: Percutaneous Nerve Block Proceduresmentioning

confidence: 99%

“…The complications occurred following stellate ganglion block procedures in the majority of cases. Because of the small diameter of the needle, it was rare for the arterial puncture itself to cause the major VAI, although a fatal VA dissection after a transforaminal C7 nerve root block or a massive bleeding causing an airway obstruction after a stellate ganglion block have been reported (71,74). Most of the casualties reported in the literature resulted from the pharmacologic effect of the materials injected via the needle: reversible grand-mal seizures or locked-in syndromes occurred after the injection of local anesthetics such as lidocaine, bupivacaine or tetracaine, and a fatal embolic cerebellar infarction occurred after the crystallized steroid injection in transforaminal nerve root block (75).…”

Section: Percutaneous Nerve Block Proceduresmentioning

confidence: 99%

Iatrogenic vertebral artery injury

Inamasu

Guiot

2005

Acta Neurol Scand

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Iatrogenic vertebral artery injury (VAI) results from various diagnostic and therapeutic procedures. The objective of this article is to provide an update on the mechanism of injury and management of this potentially devastating complication. A literature search was conducted using PubMed. The iatrogenic VAIs were categorized according to each diagnostic or therapeutic procedure responsible for the injury, i.e., central venous catheterization, cervical spine surgery, chiropractic manipulation, diagnostic cerebral angiography, percutaneous nerve block, and radiation therapy. The incidence, mechanisms of injury, and reparative procedures were discussed for each type of procedure. The type of VAI depends largely on the type of procedure. Laceration was the dominant type of acute injury in central venous catheterization and cervical spine surgery. Arteriovenous fistulae and pseudoaneurysms were the delayed complications. Arterial dissection was the dominant injury type in chiropractic manipulation and diagnostic cerebral angiography. Inadvertent arterial injection caused seizures or stroke in percutaneous nerve block. Radiation therapy was responsible for endothelial injury which in turn resulted in delayed stenosis and occlusion of the vertebral artery (VA). The proximal VA was the most vulnerable portion of the artery. Although iatrogenic VAIs are rare, they may actually be more prevalent than had previously been thought. Diagnosis of iatrogenic VAI may not always be easy because of its rarity and deep location, and a high level of suspicion is necessary for its early detection. A precise knowledge of the surgical anatomy of the VA is essential prior to each procedure to prevent its iatrogenic injury.

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“…Hematomas or vascular injury following stellate ganglion blocks and cervical discograms are rare, but have been reported (299)(300)(301) in the absence of risk factors. In a survey of 39 departments of anesthesiology in West Germany, no bleeding complications were reported among over 45,000 stellate ganglion blocks (302).…”

Section: Head and Neckmentioning

confidence: 99%

Bleeding Risk in Interventional Pain Practice: Assessment, Management, and Review of the Literature

Raj¹

2004

Pain Phys

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Delayed severe airway obstruction due to hematoma following stellate ganglion block

Abstract: We believe that the SGB needle injured the vertebral artery and caused massive hemorrhage anterior to the cervical vertebra, subsequently inducing pharyngolaryngeal edema by obstructing the venous and lymphatic drainage of the cervical region.

Cited by 12 publications

References 23 publications

Bi-national survey of Korea and Japan related to the injection site for ultrasound-guided stellate ganglion blocks and anatomic comparisons using cadaver dissection

Bi-national survey of Korea and Japan related to the injection site for ultrasound-guided stellate ganglion blocks and anatomic comparisons using cadaver dissection

Iatrogenic vertebral artery injury

Bleeding Risk in Interventional Pain Practice: Assessment, Management, and Review of the Literature

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