Stellate ganglion block, cervical sympathetic block and cervicothoracic sympathetic block

To improve the safety of the stellate ganglion block (SGB), the techniques for SGB have evolved over time from the standard blind technique to fluoroscopy and more recently to ultrasound-guided technique. Ultrasound-guided SGB may also improve the safety of the procedure by direct visualization of vascular structures and soft-tissue structures. Accordingly, the risk of vascular and soft-tissue injury may be minimized. Ultrasound guidance will allow direct monitoring of the spread of the injectate and hence may minimize complications such as recurrent laryngeal nerve (RLN) palsy and intrathecal, epidural, or intravascular spread.

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EVALUATION OF THE EXTENT OF SYMPATHETIC BLOCK OF THE ARM AFTER STELLATE-GANGLION BLOCK BY THE NINHYDRINE FINGER PRINTING TEST

Acta Anaesthesiologica Scandinavica ◽

10.1111/j.1399-6576.1967.tb00380.x ◽

1967 ◽

Vol 11 (3) ◽

pp. 153-157

Author(s):

K. G. Dhunér ◽

P. Forssblad

Keyword(s):

Stellate Ganglion ◽

Stellate Ganglion Block ◽

Sympathetic Block ◽

Ganglion Block ◽

Finger Printing

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The Successful Use of Left-sided Stellate Ganglion Block in Patients That Fail to Respond to Right-sided Stellate Ganglion Block for the Treatment of Post-traumatic Stress Disorder Symptoms: A Retrospective Analysis of 205 Patients

Military Medicine ◽

10.1093/milmed/usab056 ◽

2021 ◽

Author(s):

Sean W Mulvaney ◽

James H Lynch ◽

Kamisha E Curtis ◽

Tamara S Ibrahim

Keyword(s):

Stress Disorder ◽

Stellate Ganglion ◽

Stellate Ganglion Block ◽

Retrospective Chart Review ◽

Ptsd Symptoms ◽

Post Traumatic Stress ◽

Ganglion Block ◽

Post Traumatic ◽

Cervical Sympathetic ◽

Fight Or Flight Response

ABSTRACT Introduction Ultrasound-guided stellate ganglion block (SGB) is an injection of local anesthetic (8mL of 0.5% ropivacaine) in the neck to temporarily block the cervical sympathetic trunk which controls the body’s fight-or-flight response. This outpatient procedure takes less than thirty minutes and is immediately effective. Our goal was to determine if a left-sided stellate ganglion block is effective for treating posttraumatic stress disorder (PTSD) symptoms. While right-sided SGB has been extensively studied, left-sided SGB has not been formally evaluated for this indication. Materials and Methods Our hypothesis was that patients who fail to improve following a right-sided SGB will report significant improvement following a left-sided SGB. A retrospective chart review was conducted for patients who received SGB for PTSD symptoms between August 2019 and March 2020. All procedures were performed at an established musculoskeletal practice by the same anesthesia/pain fellowship-trained physician. Subjects included those who underwent a left-sided SGB (LSGB) only after non-response to a right-sided SGB (RSGB). Non-response was defined as less than 10 points of improvement on a PTSD Checklist (PCL-5). Results Out of 205 patients, 20 did not respond to an RSGB and were included in our analysis. Ten of these patients subsequently received an LSGB, and 90% responded favorably (PCL-5 mean improvement = 28.3 points). Conclusions Based on our sample of 205 patients receiving SGB for PTSD, we concluded that at least 4.4% did not respond to a right-sided SGB but did have a significant response to a left-sided SGB.

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