Computerized axial tomography to define the distribution of solution after stellate ganglion nerve block

Journal of Clinical Anesthesia
J M Christie, C R Martinez

Abstract

To define the spread of local anesthetic after C6 stellate ganglion nerve block using computerized axial tomography (CAT). Prospective, open descriptive study. Outpatient pain consult center. 10 ASA status I patients undergoing stellate ganglion nerve blocks for sympathetically maintained pain. Radiocontrast and local anesthetic was given in 5 ml increments to 20 ml total volume for C6 stellate ganglion nerve blocks in eight patients and C7 in two patients. CAT scanning was performed at baseline and after 5, 10, 15, and 20 ml of injectate was administered. Cervical level and pattern of injectate spread was recorded after each increment. Neck pressure above C6 did not promote caudal spread. One half of the injections were beneath prevertebral fascia. Injections on top of the fascia spread more diffusely around C6. All injections in high volume reached the medial aspect of T1 around the head, not neck, of the first rib. Solutions injected for C6 stellate ganglion nerve block concentrate medial to the stellate ganglion at T1. Thus, they must produce upper extremity sympathectomy by a mechanism other than contact with the ganglion.

References

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Citations

Feb 24, 2001·Archives of Biochemistry and Biophysics·G RoyP Gonzalez-Porqué
Oct 26, 1999·Cellular Signalling·G Berton, C A Lowell
May 14, 2009·Regional Anesthesia and Pain Medicine·Yeşim AteşIbrahim Tekdemir
Nov 19, 2009·Regional Anesthesia and Pain Medicine·Michael GofeldMarjorie Johnson
Sep 24, 2011·Regional Anesthesia and Pain Medicine·Elena K KrumovaChristoph Maier
Dec 30, 2014·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Karin WeiJustus Benrath
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Jun 3, 2008·Pain Practice : the Official Journal of World Institute of Pain·Michael Gofeld
Apr 25, 2014·Current Pain and Headache Reports·Samer Narouze
Apr 25, 2013·The Korean Journal of Pain·Neilesh Soneji, Philip Wenn Hsin Peng
Jul 25, 2007·Anesthesia and Analgesia·Yasuyuki ShibataToru Komatsu
Nov 21, 2014·The Clinical Journal of Pain·Ji Eun ShinJeong Hyun Lee
May 6, 2019·Regional Anesthesia and Pain Medicine·Xiaoying ZhuRobin J Hamill-Ruth

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