• The Korean Journal of Pain
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• v.8 no.1
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• pp.65-73
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• 1995

Idiopathic sudden sensorineural hearing loss(SNHL) is defined as a sensorineural hearing loss which develops over a period of hours or few days without a definitive causes. The etiology, prognosis, and treatment of SNHL are uncertain. We reviewed records of 76 patients to investigate the efficacy of the stellate ganglion block(SGB)in SNHL. The control group(40 patients) was managed with the medication such as hypaque, heparin, steroid, nicotinic acid, and vitamine. The SGB group(27 patients) was managed with the same medication and SGB (1~2 times/day). The efficacy of treatment was evaluated by mean dB of 500, 1000, 2000 Hz on follow up pure tone audiogram. Recovery rate above 15dB was not different between SGB and the control group (52.4 v.s. 52.0%), though SGB group has much poor prognostic factors. Recovery rate was higher in a case that was treated early. Especially, the recovery rate was 100% when SGB begins within 2 weeks from the onset. Headache and profound type of audiogram were poor prognostic factors. In conclusion, SGB within 2 weeks from the onset is recommanded to improve the recovery rate.

• The Korean Journal of Pain
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• v.7 no.1
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• pp.69-73
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• 1994

A 37 years old man who suffered from right facial palsy was treated successfully with the application of both magnetic resonance diagnostic analyser(MRA) and stellate Ganglion block(SGB). SGB is effective in treatment of facial palsy resulting from abolishing cerebral vascular spasm and increasing cerebral blood flow. Short daily period of exposure to appropriate MRA can also modulate the balance of autonomic nervous system that are responsible for sympathetic overflow resulting the edema and poor circulation on the course of the facial nerve. It was seemed that recovery of facial palsy by application of both MRA and SGB was faster than by SGB only.

• The Korean Journal of Pain
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• v.26 no.1
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• pp.57-61
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• 2013

Background: Olfactory dysfunction, including anosmia and hyposmia is difficult to treat. Although the mechanism is not well known, stellate ganglion block (SGB) is used to treat olfactory dysfunction. There are no prior studies on the long-term effects of SGB on olfactory dysfunction. The purpose of this study was to evaluate the continuity of therapeutic effects and patient satisfaction with SGB treatment. Methods: This was a follow-up study carried out via a telephonic survey. The olfactory function of the patient was evaluated using a visual analog scale (VAS). We checked VAS three times: VAS-I (pre-treatment VAS), VAS-A (post-treatment VAS), and VAS-C (VAS at follow up telephone survey). We divided the subjects into 2 groups according to their responsiveness to SGB: the responsive (R group) and the unresponsive groups (UR group). Patient satisfaction was evaluated using a Likert scale. Results: Out of the 40 subjects, 37 responded to the telephone survey. In the UR group, there was difference in the olfactory function. However, in the R group, there were significant VAS differences; VAS-I was $9.6{\pm}0.7$, VAS-A was $5.1{\pm}4.2$, and VAS-C was $2.7{\pm}$2.7 (P < 0.05). On the Likert scale, patient satisfaction was as follows: grade 1, 17 patients (45.9%); grade 2, 6 patients (16.2%); grade 3, 6 patients (16.2%); and grade 4, 8 patients (21.6%). Conclusions: SGB is a safe, long-lasting, and effective therapeutic modality for olfactory dysfunction treatment.

• Journal of Yeungnam Medical Science
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• v.31 no.2
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• pp.135-138
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• 2014

A 34-year-old female was suffered from pain and numbness of right arm for 2 months after undergoing a thoracoscopic procedure for a posterior mediastinal mass that was diagnosed as neurilemmoma. The patient was diagnosed as a complex regional pain syndrome type 2 with brachial plexopathy developed during thoracoscopic excision of posterior mediastinal mass, and stellate ganglion block (SGB) with 0.2% ropivacaine 10 mL was performed every 3-4 days. The patient revealed slightly prolonged blepharoptosis as Horner syndrome accompanied after every SGB and recovered. However, following the 23rd SGB, the blepharoptosis persisted and patient was recovered spontaneously from blepharoptosis after about 12 months. The possibility that the persistent blepharoptosis might be caused by brachial plexopathy related to patient's pathology or surgical manipulation and/or repeated SGB. If Horner syndrome occurs, its etiology should be assessed, and it would be necessary to explain and to assure the patient the possibility of recovery spontaneously from the complication within a year, without any sequelae.

• The Korean Journal of Pain
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• v.36 no.2
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• pp.216-229
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• 2023

Background: The role of the sympathetic nervous system appears to be central in causing pain in complex regional pain syndrome (CRPS). The stellate ganglion block (SGB) using additives with local anesthetics is an established treatment modality. However, literature is sparse in support of selective benefits of different additives for SGB. Hence, the authors aimed to compare the efficacy and safety of clonidine with methylprednisolone as additives to ropivacaine in the SGB for treatment of CRPS. Methods: A prospective randomized single blinded study (the investigator blinded to the study groups) was conducted among patients with CRPS-I of the upper limb, aged 18-70 years with American Society of Anaesthesiologists physical status I-III. Clonidine (15 ㎍) and methylprednisolone (40 mg) were compared as additives to 0.25% ropivacaine (5 mL) for SGB. After medical treatment for two weeks, patients in each of the two groups were given seven ultrasound guided SGBs on alternate days. Results: There was no significant difference between the two groups with respect to visual analogue scale score, edema, or overall patient satisfaction. After 1.5 months follow-up, however, the group that received methylprednisolone had better improvement in range of motion. No significant side effects were seen with either drug. Conclusions: The use of additives, both methylprednisolone and clonidine, is safe and effective for the SGB in CRPS. The significantly better improvement in joint mobility with methylprednisolone suggests that it should be considered promising as an additive to local anaesthetics when joint mobility is the concern.

• The Korean Journal of Pain
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• v.13 no.2
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• pp.187-190
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• 2000

Background: From our clinical experience, there were some problems in paratracheal stellate ganglion block at 6th cervical level (C 6 SGB), for example, lesser change in blood flow of the upper extremity and more occurrence of hoarseness. This study was undertaken to compare the various effectiveness of C 6 SGB and paratracheal stellate ganglion block at 7th cervical level (C 7 SGB). Methods: Forty patients were equally divided into 2 groups. In the Group I, patients were undertaken C 6 SGB with 0.25% bupivacaine 6 mL and in the Group II, patients were undertaken C 7 SGB with 0.25% bupivacaine 6mL. The skin temperature of index finger was measured before and after SGB and the warm sensation on face and upper extremity, hoarseness and upper extremity paralysis were studied. Results: The skin temperature of index finger was increased significantly from $33.95{\pm}0.89^{\circ}C$ to $34.51{\pm}0.90^{\circ}C$ in the Group I and from $33.94{\pm}0.82^{\circ}C$ to $35.38{\pm}0.66^{\circ}C$ in the Group II (P<0.05) The increase of skin temperature of index finger after procedure was $0.56{\pm}0.09^{\circ}C$ in the Group I and $1.44{\pm}0.02^{\circ}C$ in the Group II. The increase of skin temperature of index finger in the Group II was more statistically significant than Group I (P<0.05). The occurance of hoarseness in the Group II was significantly less than in the Group I. There was no significant difference in warm sensation on face and upper extremity and paralysis of upper extremity in both Groups. Conclusions: C 7 SGB showed better sympathetic block effect on upper extremity than C 6 SGB and hoarseness did not occur in C 7 SGB.

• The Korean Journal of Pain
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• v.4 no.2
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• pp.133-136
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• 1991

Stellate ganglion block was performed in 15 patients with intractable glaucoma by injection of 8 ml of 1y lidocaine. The followings are the changes of intraocular pressure(mmHg): Pre -block $32.26{\pm}4.44$ 10 minutes after block $36.80{\pm}4.60$ 20 minutes after block $32.61{\pm}4.41$ 30 minutes after block $28.87{\pm}4.30$ 60 minutes after block $24.73{\pm}4.37$ 120 minutes after block $26.87{\pm}3.18$ 180 minutes after block $31.40{\pm}3.76$ The pressure rose up to 10 minutes post block and significant pressure descent was noticed from 30 minutes post-block. Maximum descent was seen by 60 minutes post-block and pre-block pressure was restored by 180 minutes post-block. For the purpose of cheeking the treatment effect, similar blocks were performed in 15 patients, one time daily for 5~8 days 3 times every othor day.

• The Korean Journal of Pain
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• v.3 no.2
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• pp.165-171
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• 1990

The reflex sympathetic dystrophy syndrome (RSDS) consists of sustained burning pain and tenderness, vasomotor instabilitiy, swelling, occasional functional instability, trophic skin change and edema of extremity following trauma, peripheral nerve injury, spinal cord injury, infection, burn and other etiologic factors. The most important thing in RSDS is to start the treatment as soon as the disease was diagnosed. Most patients with RSDS respond dramatically and permanently to sympathetic blocks if treatment is instituted before irreversible trophic changes. The characteristic radiological finding in RSDS is a patchy osteoporosis in the cancellous bone. Periarticular hyperactivity is seen in RSDS by Tc99m bone scan. We have managed 4 cases of RSDS. The methods of management and effects are as follows: 1) In case 1, 28 lumbar sympathetic blocks in both sides were performed. The patient did not complain of pain or tenderness and the limping improved. 2) In case 2, 7 lumbar sympathetic blocks were performed, but we could find only a slight improvement in the symptoms. 3) In case 3, 8 stellate ganglion blocks were carried out. The patient refused the treatment of RSDS because of the lack of rapid improvement. 4) In case 4, total 64 stellate ganglion blocks were carried out; the patient was permanently improved.

• The Korean Journal of Pain
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• v.18 no.1
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• pp.85-88
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• 2005

Encephalitis is known as a rare complication of varicella zoster virus (VZV) reactivation. It is usually regarded as a complication of a cutaneous infection in patients with impaired cellular immunity. The reported incidence of herpetic motor involvement range between 0.5 and 31%, but is possibly more frequent as the weakness is readily obscured by pain. A 53-years-old woman, who presented with severe shoulder pain, fever, headache and seizure, which developed the day after skin eruptions, also developed motor paresis 7 days after the seizure. Her cerebrospinal fluid (CSF) was VZV-Polymerase chain reaction (PCR) negative, but VZV specific IgG antibody positive, and her brain MRI was found to be normal. With the early diagnosis and proper treatment, such as intravenous administration of acyclovir, stellate ganglion block and Yamamoto New Scalp Stimulation (YNSS), the patient completely recovered, without psychoneurological sequelae. Herein, we present this case, with a discussion of the relevant literature on the incidence, pathophysiology, diagnosis and management of central nervous system VZV involvement.

• The Korean Journal of Pain
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• v.20 no.2
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• pp.246-250
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• 2007

We report here on a case of right side spasmodic torticollis (ST) that was refractory to botulinum toxin type A injection and medication. The patient finally underwent a selective ramisectomy with ipsilateral sternocleidomastoid muscle (SCM) resection, but the remaining symptoms slowly aggravated, and a contralateral left side SCM spasm began. As conservative therapy for reducing the spasmodic symptoms, accessory nerve block, upper cervical plexus block and stellate ganglion block were performed twice in a week. After 6 months, the spasmodic symptoms significantly decreased. The Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) decreased by more than 70%. After one year of serial intermittent local anesthetic blockade therapy, the patient became almost free from the original ST symptoms (TWSTRS = 1). Serial local anesthetic interventions for the ST patient may have a beneficial role on the pathological peripherocentral neural activity of the ST patient and can modulate motor-sensory integration in the patient.