scholarly journals Several aspects of stellate ganglion block

Pain medicine ◽  
2018 ◽  
Vol 3 (2) ◽  
pp. 62-66
Author(s):  
E. P. Yevstratov ◽  
N. V. Krupskaya ◽  
V. Y. Shumlyanskiy
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Cluster Headache ◽  
Stellate Ganglion ◽  
Stellate Ganglion Block ◽  
Resistive Index ◽  
Ganglion Block ◽  
Ultrasound Technique ◽  
Blood Flow Reduction ◽  
The Difference

Background and Study Goal. Stellate ganglion block (SGB) has been used in the treatment of cerebral derangements associated with headache, for the purpose of reliving spasm and presumably increasing the cerebral blood flow, normalizing endovascular resistance. Materials and Methods. 30 volunteers underwent unilateral SGB, 30–40 years (21 females, 9 males), with cluster headache. 5 ml 0,25 % ropivacaine were administered + 4 mg dexamethasone under C6 level paratracheal ultrasound guid. The confirmation was the presence of Horner´s syndrome. The resistive index (RI) was measured by ultrosound transcranial CV doppler of middle cerebral artery at the baseline and 1 min, and 10 min after SGB on both sides (the other side was taken for control). Normal values of RI corresponded to the age. Results and discussion. Our observations showed that after SGB in all patients there was a significant change in RI with normalization of cerebral blood flow, reduction or disappearance of headache. Conclusions. The difference between the block and the nonblock sides was significant before procedure (p < 0,0001) and after 10 min become the same with an insignificant difference (p = 0,001). A higher RI in patients with a cluster headache may be as an indicator for choosing the block side. Ultrasound technique will be helpfull for providing safe block and effect control.

Decrease of blood flow velocity in the middle cerebral artery after stellate ganglion block following aneurysmal subarachnoid hemorrhage: a potential vasospasm treatment?

2020 ◽  
Vol 133 (3) ◽  
pp. 773-779
Author(s):  
Christopher Wendel ◽  
Ricardo Scheibe ◽  
Sören Wagner ◽  
Wiebke Tangemann ◽  
Hans Henkes ◽  
...  
Keyword(s):  
Blood Flow ◽  
Subarachnoid Hemorrhage ◽  
Middle Cerebral Artery ◽  
Flow Velocity ◽  
Neurological Deficit ◽  
Blood Flow Velocity ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Stellate Ganglion ◽  
Stellate Ganglion Block ◽  
Ganglion Block

OBJECTIVECerebral vasospasm (CV) is a delayed, sustained contraction of the cerebral arteries that tends to occur 3–14 days after aneurysmal subarachnoid hemorrhage (aSAH) from a ruptured aneurysm. Vasospasm potentially leads to delayed cerebral ischemia, and despite medical treatment, 1 of 3 patients suffer a persistent neurological deficit. Bedside transcranial Doppler (TCD) ultrasonography is used to indirectly detect CV through recognition of an increase in cerebral blood flow velocity (CBFV). The present study aimed to use TCD ultrasonography to monitor how CBFV changes on both the ipsi- and contralateral sides of the brain in the first 24 hours after patients have received a stellate ganglion block (SGB) to treat CV that persists despite maximum standard therapy.METHODSThe data were culled from records of patients treated between 2013 and 2017. Patients were included if an SGB was administered following aSAH, whose CBFV was ≥ 120 cm/sec and who had either a focal neurological deficit or reduced consciousness despite having received medical treatment and blood pressure management. The SGB was performed on the side where the highest CBFV had been recorded with 8–10 ml ropivacaine 0.2%. The patient’s CBFV was reassessed after 2 and 24 hours.RESULTSThirty-seven patients (male/female ratio 18:19), age 17–70 years (mean age 49.9 ± 11.1), who harbored 13 clipped and 22 coiled aneurysms (1 patient received both a coil and a clip, and 3 patients had 3 untreated aneurysms) had at least one SGB. Patients received up to 4 SGBs, and thus the study comprised a total of 76 SGBs.After the first SGB, CBFV decreased in 80.5% of patients after 2 hours, from a mean of 160.3 ± 28.2 cm/sec to 127.5 ± 34.3 cm/sec (p < 0.001), and it further decreased in 63.4% after 24 hours to 137.2 ± 38.2 cm/sec (p = 0.007). A similar significant effect was found for the subsequent SGB. Adding clonidine showed no significant effect on either the onset or the duration of the SGB. Contralateral middle cerebral artery (MCA) blood flow was not reduced by the SGB.CONCLUSIONSTo the authors’ knowledge, this is the largest study on the effects of administering an SGB to aSAH patients after aneurysm rupture. The data showed a significant reduction in ipsilateral CBFV (MCA 20.5%) after SGB, lasting in about two-thirds of cases for over 24 hours with no major complications resulting from the SGB.

Evaluation of stellate ganglion block on auricular skin blood flow by laser-doppler flowmetry

1995 ◽  
Vol 56 (1-2) ◽  
pp. 135-136
Author(s):  
Kenji Imai ◽  
Keisou Ishimaru ◽  
Masahiro Iwa ◽  
Toshikatsu Kitade ◽  
Sadayuki Sasaki ◽  
...  
Keyword(s):  
Blood Flow ◽  
Laser Doppler Flowmetry ◽  
Skin Blood Flow ◽  
Stellate Ganglion ◽  
Stellate Ganglion Block ◽  
Laser Doppler ◽  
Ganglion Block ◽  
Doppler Flowmetry

Blood Flow in Common Carotid and Vertebral Arteries in Patients with Sudden Deafness

1997 ◽  
Vol 106 (1) ◽  
pp. 27-32 ◽  
Author(s):  
Yoshimitsu Ohinata ◽  
Shin-Ichi Haginomori ◽  
Kazuo Makimoto ◽  
Michitoshi Araki ◽  
Michiro Kawakami ◽  
...  
Keyword(s):  
Blood Flow ◽  
Stellate Ganglion ◽  
Stellate Ganglion Block ◽  
Sudden Deafness ◽  
Control Group ◽  
Ganglion Block ◽  
Male Patients ◽  
The Common ◽  
Normal Adults ◽  
Carotid And Vertebral Arteries

Blood flow was measured in the common carotid artery (CCA) and the vertebral artery (VA) by the ultrasonic Doppler method in 14 male patients with sudden deafness and 70 normal adults. In the patients, blood flow on the affected side was slower than that on the normal side or that of the control group. Although these differences were not statistically significant in the CCA or in the VA, significant differences in the blood flow were noted between the group with a hearing loss of greater than 50 dB and the group with a loss of less than 50 dB. A negative correlation was found between blood viscosity and blood flow in both CCAs and both VAs. After stellate ganglion block (SGB), the blood flow of the CCA and VA increased on the side of the SGB and decreased on the opposite side. The changes in blood flow after SGB decreased with age, presumably because of changes in the blood vessel walls and a weaker response to sympathetic nerve receptors in the arterial wall.

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