scholarly journals Real-Time Ultrasound-Guided Stellate Ganglion Block for Migraine: An Observational Study

2021 ◽  
Author(s):  
Jiawei Hou ◽  
Shaofeng Pu ◽  
Junzhen Wu ◽  
Zhiqiang Lu ◽  
Xingguo Xu
Keyword(s):  
Side Effects ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Stellate Ganglion ◽  
Stellate Ganglion Block ◽  
Ultrasound Guided ◽  
Ganglion Block ◽  
Numerical Rating

Abstract Objective. To observe whether ultrasound-guided stellate ganglion block (SGB) can effectively relieve migraine pain and improve the quality of migraine patients’ life.Methods. 81 patients with migraines were enrolled in this trial. The patients received SGB with 6 ml of 0.15% ropivacaine once every week for four times. Migraine was assessed with the Migraine Disability Assessment Scale (MIDAS) at baseline and three-months follow-up (Tm). The numerical rating scale (NRS) score at baseline, one day after treatment (Td) and Tm, the frequency of analgesic use in 3 months and the side effects were also recorded at the same time.Results. The NRS score of migraine subjects decreased significantly from 7.0 (2.0) to 3.0 (1.0) at Td and 2.0 (2.0) at Tm (vs baseline, P<0.01). The MIDAS total scores were 14.0 (10.5) at baseline and 7.0 (4.5) at Tm (P<0.001). During the three months, the frequency of analgesic consumption was decreased from 6.2 ± 2.8 to 1.9±1.8. There were no serious side effects. Conclusions. This study confirmed that ultrasound-guided SGB is an effective method to treat migraines. This technique can reduce pain and disability and then improve the quality of life of patients with migraines.

scholarly journals Effectiveness of Operative and Nonoperative Care for Adult Spinal Deformity: Systematic Review of the Literature

2017 ◽  
Vol 7 (2) ◽  
pp. 170-178 ◽  
Author(s):  
Alisson R. Teles ◽  
Tobias A. Mattei ◽  
Orlando Righesso ◽  
Asdrubal Falavigna
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Short Form ◽  
Adult Spinal Deformity ◽  
Numerical Rating ◽  
Short Form Health

Study Design: Systematic review. Objective: There is a need for synthesizing data on effectiveness of treatments for patients with adult spinal deformity (ASD) due to its increasing prevalence and health care costs for these patients. The objective of this review was to estimate the effectiveness of surgery versus nonoperative care in patients with ASD. Methods: A systematic review of articles in published in English using PubMed between 2005 and 2015. Surgical and nonsurgical series that reported baseline and follow-up health-related quality of life measures of patients with ASD with a minimum 2 years of follow-up were selected. Independent extraction of articles by 2 authors using predefined data fields, including risk of bias assessment. Results: Surgery significantly reduces disability, pain, and improves patients’ quality of life. The average postoperative improvement in Oswestry Disability Index was −19.1 (±9.0), Numerical Rating Scale back pain −4.14 (±1.38), Numerical Rating Scale leg pain −3.36 (±1.33), Short-Form Health Survey 36-SF36-Physical Component score 11.2 (±5.07), and Short-Form Health Survey 36-Mental Component score 9.93 (±4.96). The complication rate ranged from 9.52% to 81.52% (mean = 39.62%), and the need for revision surgery ranged from 1.72% to 40.0% (mean = 15.71%). The best existing evidence about nonoperative care of ASD is provided from observational studies with very high risk of bias. Quantitative analyses of nonsurgical cohorts did not demonstrate significant changes in quality of life of patients after 2 years of observation. Conclusions: This data may assist clinicians to counsel patients, as well as to inform health care providers and policymakers about what to expect from the treatment for ASD.

scholarly journals A Randomized Comparison between 4, 6 and 8 mL of Local Anesthetic for Ultrasound-Guided Stellate Ganglion Block

2019 ◽  
Vol 8 (9) ◽  
pp. 1314
Author(s):  
Yongjae Yoo ◽  
Chang-soon Lee ◽  
Yong-Chul Kim ◽  
Jee Youn Moon ◽  
Roderick J. Finlayson
Keyword(s):  
Side Effects ◽  
Local Anesthetic ◽  
Stellate Ganglion ◽  
Stellate Ganglion Block ◽  
Sympathetic Blockade ◽  
Success Rates ◽  
Ultrasound Guided ◽  
Ganglion Block ◽  
Temperature Changes ◽  
The Face

Background: Because it affords greater accuracy than landmark-based techniques, ultrasound guidance may reduce the volume of local anesthetic required for sympathetic blockade of the upper extremity. We hypothesized that 4 mL would provide a similar clinical effect when compared to larger volumes. Methods: One hundred and two patients with chronic neuropathic pain of the upper extremity or face were randomly assigned to receive an ultrasound-guided (USG) stellate ganglion block (SGB) with either 4 mL (group A), 6 mL (group B) or 8 mL (group C) mL of 1.0% lidocaine. Skin temperatures of the face, hand, and axillary fold were measured bilaterally at baseline, 10, 20, and 30 min after the block. Our primary outcome was the relative increase in hand temperature on the blocked side at 30 min and our non-inferiority margin was −0.6 °C. Secondary outcomes included success rate (as defined by a relative temperature increase of ≥1.5 °C), pain relief, degree of ptosis and side-effects. Results: The 95% confidence intervals for the difference of the means exceeded our non-inferiority margin (A versus B: −0.76 to 0.24; A versus C: −0.89 to 0.11) for temperature changes in the hand; however, success rates were similar (44, 45 and 55% for A, B and C respectively, p = 0.651). No intergroup differences were found in temperature-related outcomes for the other measurement sites (face, axilla). The incidence of minor side-effects was significantly higher in group C and no block-related complications were noted. Conclusions: We were unable to establish the non-inferiority of a 4 mL volume for sympathetic blockade of the hand. The clinical significance of these findings is unclear as success rates were similar between the different groups. In contrast, the 6- and 8 mL volumes were not associated with greater temperature changes in the face and axilla.

scholarly journals Rhomboid intercostal block combined with sub-serratus plane block versus rhomboid intercostal block for postoperative analgesia after video-assisted thoracoscopic surgery: a prospective randomized-controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wei Deng ◽  
Xiao-min Hou ◽  
Xu-yan Zhou ◽  
Qing-he Zhou
Keyword(s):  
Rating Scale ◽  
Numerical Rating Scale ◽  
Thoracoscopic Surgery ◽  
Controlled Trial ◽  
Ultrasound Guided ◽  
Video Assisted ◽  
Prospective Randomized Controlled Trial ◽  
Numerical Rating ◽  
Intercostal Block ◽  
Video Assisted Thoracoscopic Surgery

Abstract Background Rhomboid intercostal block (RIB) and Rhomboid intercostal block with sub-serratus plane block (RISS) are the two types of plane blocks used for postoperative analgesia after video-assisted thoracoscopic surgery (VATS). This prospective randomized controlled trial was performed to analyze the postoperative analgesic effects of ultrasound-guided RIB block and RISS block after video-assisted thoracoscopic surgery. Methods Ninety patients aged between 18 and 80 years, with American Society of Anesthesiologists physical status Classes I–II and scheduled for elective unilateral VATS were randomly allocated into three groups. In group C, no block intervention was performed. Patients in group RIB received ultrasound-guided RIB with 20-mL 0.375% ropivacaine and those in group RISS received ultrasound-guided RIB and serratus plane block using a total of 40-mL 0.375% ropivacaine. All patients received intravenous sufentanil patient-controlled analgesia upon arrival in the recovery room. Postoperative sufentanil consumption and pain scores were compared among the groups. Results The dosages of sufentanil consumption at 24 h after the surgery in the RIB and RISS groups were significantly lower than that in group C (p < 0.001 and p < 0.001 for all comparisons, respectively), the postoperative Numerical Rating Scale (NRS) scores in the RIB and RISS groups at 0.5, 1, 3, 6, 12, 18, and 24 h after surgery when patients were at rest or active were significantly lower than that in group C (p < 0.05 for all comparisons). The required dosage of sufentanil and time to first postoperative analgesic request in groupRISS were less than those in the group RIB at 24 h after the surgery (p < 0.001 and p < 0.001 for all comparisons, respectively). Similarly, the Numerical Rating Scale scores for group RISS at 12, 18, and 24 h after the surgery when the patients were active were significantly lower than those for group RIB (p < 0.05 for all comparisons). Conclusion Both ultrasound-guided RIB block and RISS block can effectively reduce the demand for sufentanil within 24 h after VATS, and less sufentanil dosage is needed in patient with RISS block. Ultrasound-guided RIB block and RISS block can effectively relieve pain within 24 h after VATS, and RISS block is more effective.

scholarly journals Clinical Efficacy of Scalene Injection for Thoracic Outlet Syndrome

2021 ◽  
Author(s):  
Samuel Baek ◽  
Seok Kim ◽  
Myung Ho Shin ◽  
Tae Min Kim ◽  
Seoung-Joon Lee ◽  
...  
Keyword(s):  
Side Effects ◽  
Clinical Efficacy ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Neck Disability Index ◽  
Vital Signs ◽  
Treatment Technique ◽  
The Novel ◽  
Numerical Rating ◽  
Neck Disability

Purpose: We introduce the novel treatment technique, scalene injection, and study its clinical efficacy for diagnosis, treatment, and pain control for patients with thoracic outlet syndrome.Methods: Between November 2001 and October 2018, 266 patients were studied retrospectively. To evaluate the efficacy and sustainability, we checked the numerical rating scale (NRS) for pain relief and neck disability index (NDI) for functional improvements, prior to and 1, 12 weeks after the injection. The safety was evaluated by examining side effects for at least 24 hours from the point of injection.Results: NRS was improved from 7.12 to 3.11 at 1 week, and to 3.05 at 12 weeks (p<0.05). NDI was improved from 15.87 to 6.15 at 1 week, and to 6.19 at 12 weeks (p<0.05). There were two cases of convulsion immediately after the injection and were treated with prompt oxygen supply and sedatives. Transient side effects included two cases of dyspnea and one case of nausea and were resolved within 1 hour after. All five cases showed symptoms of side effects on the day of injection and were resolved within a day. A total of 242 patients (91.0%) experienced immediate declines in NRS and 161 patients experienced persistent declines for more than 12 weeks. However, 24 patients (9.0%) showed no improvement and 20 patients (7.5%) experienced increases in NRS.Conclusion: Scalene injection is also effective as a therapeutic method. However, this study suggests that it must be done with monitoring of vital signs in an operating room for any possible complications and side effects.

scholarly journals A Case Report on a Patient Treated with Combined Korean Medicine for Chronic Headache with Digestive Symptoms

2021 ◽  
Vol 42 (5) ◽  
pp. 923-90
Author(s):  
Gyu-cheol Choi ◽  
Ji-eun Bae ◽  
Jae-won Park ◽  
Dong-jin Kim ◽  
Jeong-su Hong
Keyword(s):  
Medical Treatment ◽  
Chronic Headache ◽  
Impact Test ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Five Dimensions ◽  
End Of Treatment ◽  
Numerical Rating ◽  
Headache Impact

Objectives: The purpose of this study was to examine the effect of combined Korean medical treatment on chronic headache with digestive symptoms.Methods: We collected data from October to December 2020 and evaluated the efficacy of combined Korean medical treatment using the Korean Headache Impact Test-g (KHIT-6), European Quality of Life Five Dimensions (EQ5D) Scale, and Numerical Rating Scale (NRS) at admission, after two weeks of hospitalization, and on discharge.Results: At the end of treatment, the patient had increased EQ5D and reduced KHIT-6 and NRS scores.Conclusions: After the combined Korean medical treatment, the patient showed improvement, suggesting the efficacy of treatment.

scholarly journals Magnesium Sulfate as an Adjuvant in Ultrasound Guided Stellate Ganglion Block for Post Mastectomy Pain Syndrome

2021 ◽  
Vol 89 (6) ◽  
pp. 975-985
Author(s):  
GHADA F. AL-RAHMAWY, M.D.; ENAS A. ABD AL-MOTELEB, M.D. ◽  
MONA G. EL-EBEIDY, M.D.; MOHAMED A. HAFEZ, M.Sc.
Keyword(s):  
Magnesium Sulfate ◽  
Stellate Ganglion ◽  
Stellate Ganglion Block ◽  
Pain Syndrome ◽  
Ultrasound Guided ◽  
Ganglion Block

scholarly journals Percutaneous Osteoplasty under Fluoroscopy and Cone-Beam CT guidance for Painful Sternal Metastases

2021 ◽  
Author(s):  
Xun-wei Liu ◽  
Zhi-guo Wang ◽  
Jin Peng ◽  
Gang Sun
Keyword(s):  
Rating Scale ◽  
Numerical Rating Scale ◽  
Cone Beam Ct ◽  
Tumor Location ◽  
Cone Beam ◽  
Ct Guidance ◽  
Numerical Rating ◽  
Cement Distribution ◽  
Painful Bone Metastases

Abstract Background: Although percutaneous osteoplasty (POP) has been widely accepted and is now being performed for the treatment of painful bone metastases outside the spine, there are only scarced reports regarding osteoplasty in painful sternal metastases.Case presentation: The paper reported four patients with painful sternal metastasis who underwent POP under fluoroscopic and cone-beam CT guidance. The patients were three men and one woman (mean age, 66.25 years). Primary tumor location in lung is 3 cases, in thyroid is 1 case. In these cases, Pain was measured using a numerical rating scale (NRS), with scores ranging from 0 (no pain) to 10 (worst pain imaginable). The scores on the NRS in the four patients before POP were 9, 8, 8, and 9. After POP, the NRS scores decreased to 2, 3, 2, and 2, respectively, in follow-up at 6 months. Conclusions: POP is a safe and effective treatment for pain caused by metastatic bone tumors in the sternum. However, care and at tention should be paid to the insertion of a needle and cement distribution for better treatment effect

scholarly journals Consumptive Disease and Chronic Fatigue Improved by Nokyonggunbi-tang and Other Korean Medical Treatments: A Case Report

2021 ◽  
Vol 42 (5) ◽  
pp. 738-745
Author(s):  
Mu-jin Park ◽  
So-ri Jin ◽  
Eun-jae Oh ◽  
Woo-sub Song ◽  
Hyun-seok Lee ◽  
...  
Keyword(s):  
Rating Scale ◽  
Numerical Rating Scale ◽  
Neck Disability Index ◽  
Chronic Fatigue ◽  
Medical Treatments ◽  
Five Dimensions ◽  
Numerical Rating ◽  
Fatigue Severity ◽  
Neck Disability

Objective: This study investigated the efficacy of using Nokyonggunbi-tang and other Korean medical treatments for a patient with consumptive disease and chronic fatigue.Methods: A 59-year-old female patient with fatigue, headache, dizziness, and neck pain due to consumptive disease and chronic fatigue was treated with herbal medicine (Nokyonggunbi-tang), together with acupuncture, pharmacopuncture, cupping, and chuna manual therapy, for 22 days. The treatment effects on the pain were evaluated using the scores for the Fatigue Severity Scale (FSS), European Quality of Life Five Dimensions (EQ-5d) Scale, Neck Disability Index (NDI), and Numerical Rating Scale (NRS).Results: Following treatment, the patient showed a decrease in the FSS, NDI, and NRS scores and an improvement in the EQ-5d score.Conclusions: Nokyonggunbi-tang and Korean medical treatment significantly improved fatigue symptoms in a patient with no substrate disease.

Effect of Visual Feedback During Ultrasound-Guided Interfascial Injection for Myofascial Pain Syndrome: A Prospective, Multicenter, Observational Clinical Trial

2021 ◽  
Author(s):  
Hideaki Hasuo ◽  
Hideya Oomori ◽  
Kohei Yoshida ◽  
Mikihiko Fukunaga
Keyword(s):  
Visual Feedback ◽  
Rating Scale ◽  
Myofascial Pain ◽  
Numerical Rating Scale ◽  
Pain Syndrome ◽  
Myofascial Pain Syndrome ◽  
Ultrasound Guided ◽  
Feedback Group ◽  
Treatment Expectations ◽  
Numerical Rating

Abstract Background: Expectations for treatment have a favorable effect on the subsequent course of pain and behavior in patients. It is not known whether receiving interfascial injection while patients view their ultrasound image with doctors (visual feedback) is associated with positive treatment expectations. Methods: This was a prospective, multicenter, observational clinical trial. We evaluated whether visual feedback during ultrasound-guided interfascial injection affects treatment expectations and the subsequent course of pain in patients with myofascial pain syndrome. Treatment expectations were set as mediators of pain using path analysis. The primary endpoint was the proportion of patients who showed improvement in pain numerical rating scale score by 50% or more 14 days after initiation of treatment. Results: During 2019 and 2020, 136 outpatients received ultrasound-guided interfascial injection for myofascial pain syndrome. Of these, 65 (47.8%) patients received visual feedback during ultrasound-guided interfascial injection. Compared with the non-visual feedback group, the visual feedback group had higher expectations for treatment, immediately after interfascial injection, and their expectations were maintained at day 14 of treatment (p < .001). In the visual feedback group, 67.7% of patients showed improvement in pain numerical rating scale score by 50% or more at day 14 (95% confidence interval: 56.5–78.9), whereas such improvement was observed in only 36.6% of the non-visual feedback group (95% confidence interval: 25.3–47.9; p < .001). Path analysis revealed that visual feedback had the largest influence on pain numerical rating scale reduction at 14 days, which was indirectly via higher expectations for treatment (β = 0.434).Conclusions: Visual feedback during ultrasound-guided interfascial injection had a positive effect on the subsequent course of pain in patients with myofascial pain syndrome by increasing patients’ treatment expectations.Trial registration: UMIN000043160. Registered 28 January 2021 (registered retrospectively).

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