Journal of Yeungnam Medical Science

Original Articles

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

Attenuation of pneumoperitoneum-induced hypertension by intra-peritoneal lidocaine before pneumoperitoneum in laparoscopic cholecystectomy.: Sun Ok Song, Hae Mi Lee, Sung Soo Yun, Hwarim Yu, Soo Young Shim, Heung Dae Kim; Yeungnam Univ J Med. 2016;33(2):90-97. Published online December 31, 2016; DOI: https://doi.org/10.12701/yujm.2016.33.2.90

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Abstract PDF: BACKGROUND
We have previously found that intra-peritoneal lidocaine instillation before pneumoperitoneum attenuates pneumoperitoneum-induced hypertension. Whether this procedure alters patient's hemodynamic status during operation should be determined for clinical application. This study elucidated the possible mechanism of the attenuation of the pneumoperitoneum-induced hypertension by intra-peritoneal lidocaine before pneumoperitoneum. METHODS: Thirty-four patients underwent laparoscopic cholecystectomy (LC) were randomly allocated into two groups. After induction of general anesthesia, 200 mL of 0.2% lidocaine (lidocaine group, n=17), or normal saline (control group, n=17) were sub-diaphragmatically instilled 10 minutes before pneumoperitoneum. The changes in systolic blood pressure, heart rate, central venous pressure, stroke volume, cardiac output, and systemic vascular resistance were compared between the groups. The number of analgesics used during post-operative 24 h was compared. RESULTS: Systolic blood pressure was elevated during pneumoperitoneum in both groups (p<0.01), but the degree of elevation was significantly reduced in the lidocaine group than in the control (p<0.01). However, stroke volume and cardiac output were decreased and systemic vascular resistance was increased after induction of pneumoperitoneum (p<0.05) without statistical difference between two groups. The number of analgesics used was significantly reduced in the lidocaine group (p<0.01). CONCLUSION: These data suggest that intra-peritoneal lidocaine before pneumoperitoneum does not alter patient's hemodynamics, and attenuation of pneumoperitoneum-induced hypertension may be the consequence of reduced intra-abdominal pain rather than the decrease of cardiac output during pneumoperitoneum. Therefore, intra-peritoneal lidocaine instillation before pneumoperitoneum is a useful method to manage an intraoperative pneumoperitoneum-induced hypertension and to control postoperative pain without severe detrimental hemodynamic effects.

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