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

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.

2021 ◽  
Author(s):  
Jiawei Hou ◽  
Shaofeng Pu ◽  
Junzhen Wu ◽  
Zhiqiang Lu ◽  
Xingguo Xu

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.


1994 ◽  
Vol 81 (SUPPLEMENT) ◽  
pp. A1008 ◽  
Author(s):  
T. Kimura ◽  
T. Komatsu ◽  
K. Nishiwaki ◽  
Y. Shimada

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.

1992 ◽  
Vol 6 (1) ◽  
pp. 85-90
Author(s):  
Shigeru Matsumoto ◽  
Hiromasa Mitsuhata ◽  
Jun-ichi Hasegawa ◽  
Souhaku Shigeomi ◽  
Jun-ichi Matsumoto ◽  
...  

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