• The Korean Journal of Pain
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• v.24 no.3
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• pp.141-145
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• 2011

Background: Stellate ganglion block is usually performed at the transverse process of C6, because the vertebral artery is located anterior to the transverse process of C7. The purpose of this study is to estimate the location of the transverse process of C6 using the cricoid cartilage in the performance of stellate ganglion block. Methods: We reviewed cervical lateral neutral-flexion-extension views of 48 patients who visited our pain clinic between January and June of 2010. We drew a horizontal line at the surface of the cricoid cartilage in the neutral and extension views of cervical lateral x-rays. We then measured the change in the shortest distance from this horizontal line to the lowest point of the transverse process of C6 between the neutral and extension views. Results: There was a statistically significant difference in the shortest distance from the horizontal line at the surface of the cricoid cartilage to the lowest point of transverse process of C6 between neutral position and neck extension position in both males and females, and between males and females in both neutral position and neck extension position. The cricoid cartilage level was 4.8 mm lower in males and 14.4 mm higher in females than the lowest point of transverse process of C6 in neck extension position. Conclusions: Practitioners should recognize that the cricoid cartilage has cephalad movement in neck extension. In this way, the cricoid cartilage can be still useful as a landmark for stellate ganglion block.

• The Korean Journal of Pain
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• v.1 no.2
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• pp.211-213
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• 1988

Efforts from many different approaches have been made to cure Raynaud's phenomenon using dosal sympathectomy and topical injection of nitroglycerine, phentolamine or procaine and oral or parenteral administration of various drugs. However, there has been no successful management proven yet. In recent years, it was reported that intra-arterial adminstriation of various drugs in normal subjects as well as patients with Raynaud's syndrome, had emonstrated a significant increase in blood flow to the hands. We used an intermittent stellate ganglion block in conjunction with intra-arterial injection of reserpine and procaine in the patient suffering from finger necrosis caused by accidental intraarterial antibiotic (cephamezine) injection. The stellate ganglion block was performed via a paratracheal approach by injection of 0.5% bupivacaine 6 ml, and 1% lidocaine 6 ml, and followed by administration of reserpine 1 mg and procaine 50 mg through a butterfly needle inserted in the radial artery. The administration of reserpine and procaine was done twice. The stellate ganglion block was performed every day for about 3 days, then once every a 5 days as needed for 15 days. As the procedure was carried out, the discolored tissue improved and the pain was progressively relieved. In conclusion, it was suggested that the intra-arterial administration of reserpine and procaine helped initiate and accelerate the increasing blood flow to the hand and the stellate ganglion block continued to help revascularization by dilating the peripheral beds.

• The Korean Journal of Pain
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• v.1 no.1
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• pp.16-19
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• 1988

Effects from many different approaches have been made to cure Raynaud's phenomenon, such as a dorsal sympathectomy, topical injection of nitroglycerin, phentolamin and procaine, and oral or parentral administration of various drugs. However, there has been no successful management proven yet. In recent years, it was reported that intra-arterial administration ill normal subjects as well as patients with Raynaud's syndrome has demonstrated a significant rise in blood flow to the lands. We used intermittent stellate ganglion blocks in conjunction with intra-arterial injections of reserpine and procaine in 10 patients suffering from finder necrosis. The stellate ganglion block was performed in a paratracheal approach by injection of 1% lidocaine purposely mixed with adrenaline followed by the administration of reserpine 1 mg and procaine 50 mg through a butterfly needle inserted in the radial or brachial artery. The administration of reserpine and procaine was done only twice at intervals of 1 week because of the development of suspected arteriosclerosis. The stellate ganglion block was carried out once a week for about 3 months, then once a month as needed for 6 to 12 months. As the procedure was carried out and the necrotic tissue sloughed off, oozing appeared and new granulation tissue was observed. 5 out of 10 patients were healed completely and the rest improved considerably but were not followed to the end. We concluded that the intra-arterial administration of reserpine and procaine helped initiate and accelerate increasing blood flow to the hand and the stellate ganglion block continued to help revascularization by dilating the peripheral beds.

• Journal of Dental Anesthesia and Pain Medicine
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• v.15 no.1
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• pp.35-37
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• 2015

Atypical facial pain (AFP) is a type of facial pain which does not fulfill any other diagnosis. It has several features such as no objective signs, no obvious explanation of the cause and poor response to treatments. We report a case of a female patient with AFP on the left maxillary area. The pain was increased by cold innocuous stimulation and thermography showed that the temperature on the painful area was significantly decreased. The pain was successfully alleviated by stellate ganglion block (SGB). Therefore, SGB can be effectively used to treat AFP.

• The Korean Journal of Pain
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• v.10 no.1
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• pp.121-123
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• 1997

Stellate ganglion block(SGB) is frequently performed to relieve a patient from headache of various. We experienced a rare case of subarachnoid hemorrhage by aneurysmal rupture after SGB. A 46-year-old female patient diagnosed with tension headache, and normal MRI finding consulted our pain clinic. We performed right SGB in combination with greater occipital nerve block. The next day, we performed left SGB with 6 ml of 0.25% bupivacaine. She had no evidence of subarachnoid block or intravascular injection. 15 minutes after injection, she abruptly developed convulsion and loss of consciousness. She was given artificial respiration with oxygen. The diagnosis of ruptured left posterior communicating aneurysm was confirmed by 4-vessels angiography.

• The Korean Journal of Pain
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• v.12 no.2
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• pp.235-237
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• 1999

Meniere's disease is a disorder of the membranous labyrinth that is characterized by vertigo, hearing loss, tinnitus and ear fullness. The etiology of Meniere's disease is yet to be described and the management is also very difficult. Fifty-one years old female patient had paroxysm of severe tinnitus and dizziness after medical therapy and surgical intervention during several years. Patient received stellate ganglion block (SGB) and her symptoms were completely relieved. Therefore, SGB could be considered another therapeutic modality for Meniere's disease.

• The Korean Journal of Pain
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• v.13 no.1
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• pp.115-118
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• 2000

Stellate ganglion block is most commonly used in pain clinic because it is an easy procedure and it has broad indications reported that Angina pectoris, tachyarrhythmia and long QT syndrome (LQTS) are indicated. LQTS is a disorder of the abnormalities of cardiac sympathetic innervation and of myocardial repolarization. LQTS is characterized by marked prolongation of the QT interval, often manifestating as syncope, seizures, or sudden death due to polymorphic ventricular tachyarrhythmia known as torsades de pointes. Treatment of symptomatic patients usually begin with beta blocker. The elective treatment of LQTS patients unresponsive to beta blocker is the left cardiac sympathetic denervation. We report a case of LQTS patient who had received stellate ganglion block.

• The Korean Journal of Pain
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• v.18 no.2
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• pp.232-234
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• 2005

Stellate ganglion block (SGB) is one of the most widely used treatment modalities for a broad range of disorders, including otolaryngologic indications such as Meniere's disease and sudden hearing loss. We present a case of a vertiginous attack following SGB for the management of Meniere's disease. A 31-year-old female, suffering from Meniere's disease, underwent repeated right side SGBs with 6 ml of 1% mepivacaine after negative aspiration tests for blood. The eleventh block was performed in the usual manner. Several seconds after injection, she showed agitation, anxiety, nystagmus, and left-sided tinnitus. Two minutes later, her tinnitus and nystagmus were resolved. Fifteen minutes after injection, she experienced acute onset of severe vertigo, nausea, and vomiting. However, her symptoms were gradually alleviated within two hours.

• The Korean Journal of Pain
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• v.11 no.1
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• pp.116-118
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• 1998

Stellate ganglion block(SGB) is frequently performed in pain clinics. Facial palsy produces asymmetry of the face, lagophthalmos and incomplete eyelid closure. Exposure keratitis and eyeball pain can be induced by prolonged lagophthalmos. SGB was performed on a 51-year-old female patient who had exposure of keratitis and eyeball pain due to facial nerve palsy after an operation for chronic otitis media. After 31 stellate ganglion blocks, eyeball pain and keratitis nearly subsided. SGB is an effective method to treat lagophthalmos caused by facial nerve palsy.

• The Korean Journal of Pain
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• v.21 no.1
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• pp.62-65
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• 2008

A 73-year-old man with sudden sensory neural hearing loss received a stellate ganglion block. Two hours after the block, the patient complained of newly developed neck discomfort. After an additional two hours, the neck swelled up gradually and neck pain and dyspnea developed. A plain radiograph of neck revealed narrowing of the upper airway; a tracheostomy was performed and the dyspnea was improved. On the next day, the pain site extended to the right scapula and a CT image revealed a huge retropharyngeal hematoma. Hematoma evacuation and bleeder ligation were then performed and the patient was discharged on the fourth day after admission without any complications. A practitioner should always remember to educate the patients about possible complications and undertake intensive observation when performing procedures, even in patients who do not initially present with a compromised airway.