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

Multicenter Prospective Randomized Comparison of Ultrasound-Guided Stellate Ganglion Versus Thoracic Paravertebral Block for Sympathetic Blockade in Chronic Upper Extremity Pain
Jeongsoo Kim, Joon Cha, Sheung Nyoung Choi, Gang Heo, Yongjae Yoo, Jee Youn Moon
Anesthesia & Analgesia.2025; 140(3): 665. CrossRef
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 Report

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.

Original Article

Utility of H-reflex in the Diagnosis Cervical Radiculopathy.: Jun Lee, Gun Ju Park, Hyun Cheol Doo, Sung Geon Park, Yun Seog Jeong, Jung Sang Hah; Yeungnam Univ J Med. 1997;14(1):111-122. Published online June 30, 1997; DOI: https://doi.org/10.12701/yujm.1997.14.1.111

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Abstract PDF

H-reflex is a kind of late respons which can be used for the proximal nerve conduction study. Also it is a useful and widely used nerve conduction technique es to look electrically at the monosynaptic reflex. Although recordable from all muscles theoretically, H-reflexes are most commonly recorded from the calf muscles following stimulation of the tibial nerve in the popliteal fossa. But in this study, We tried to establish the normal data and to evaluate the significance of the H-reflex study in cervical radiculopathy. H-reflexes were recorded from flexor carpi radialis (FCR) muscle, extensor carpi radialis (ECR) muscle, brachioradialis (BR) muscle, and abductor digiti minimi (ADM) muscle in 31 normal adults (62 cases) and 12 patients with cervical radiculopathy. The mean values of H-reflex latency in normal control group were 16.16+/- 1.65 msec in FCR; 15.99+/- 1.25 msec in ECR; 16.47+/- 1.59 msec in BR; 24.46+/- 1.42 msec in ADM. And the mean values of side to side difference of H-reflex latency were 0.47+/- 0.48 msec in FCR; 0.68+/- 0.72 msec in ECR; 0.63+/- 0.43 msec in BR; 22.31+/- 1.24 msec in ADM. Mean values of side to side differences of interlatency time were 0.49+/-0.47 msec in FCR; 0.73+/- 0.62 msec in ECR; 0.79+/- 0.71 msec in BR; 0.69+/- 0.44 msec in ADM. Also, there were no significant differences in H-reflex latency between right and left side. H-reflex tests in patient group with cervical radiculopathy revealed abnormal findings in 11 out of 12 patients. These results suggest that H-reflex in the upper extremity would be helpful in the diagnosis of the cervical radiculopathy.

Citations

Citations to this article as recorded by

Retraining Reflexes: Clinical Translation of Spinal Reflex Operant Conditioning
Amir Eftekhar, James J.S. Norton, Christine M. McDonough, Jonathan R. Wolpaw
Neurotherapeutics.2018; 15(3): 669. CrossRef
Abnormal Flexor Carpi Radialis H-Reflex as a Specific Indicator of C7 as Compared With C6 Radiculopathy
Chaojun Zheng, Yu Zhu, Feizhou Lv, Xiaosheng Ma, Xinlei Xia, Lixun Wang, Xiang Jin, Robert Weber, Jianyuan Jiang, Kevin Anuvat
Journal of Clinical Neurophysiology.2014; 31(6): 529. CrossRef
Utility of Flexor Carpi Radialis H-Reflex in Diagnosis of Cervical Radiculopathy
Dariush Eliaspour, Ehsan Sanati, Mohammad Reza Hedayati Moqadam, Seyed Mansoor Rayegani, Mohammad Hasan Bahrami
Journal of Clinical Neurophysiology.2009; 26(6): 458. CrossRef

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