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Transient Neuronal Injury Followed by Intravascular Injection During an Ultrasound Guided Stellate Ganglion Block

Ultrasound guidance for pain interventions is becoming increasing recognized as a useful imaging tool. One of the common interventions where it is gaining wider acceptance is during the performance of a stellate ganglion block. The following is a unique report where intravascular and neuronal injury...

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Autores principales: Shankar, Hariharan, Simhan, Swetha
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Kowsar 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3821125/
https://www.ncbi.nlm.nih.gov/pubmed/24244924
http://dx.doi.org/10.5812/aapm.7823
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author Shankar, Hariharan
Simhan, Swetha
author_facet Shankar, Hariharan
Simhan, Swetha
author_sort Shankar, Hariharan
collection PubMed
description Ultrasound guidance for pain interventions is becoming increasing recognized as a useful imaging tool. One of the common interventions where it is gaining wider acceptance is during the performance of a stellate ganglion block. The following is a unique report where intravascular and neuronal injury occurred during the performance of an ultrasound guided stellate ganglion block followed by dysphagia. 41 year old male, with a diagnosis of complex regional pain syndrome, was referred to our clinic for further management. He underwent a diagnostic ultrasound guided stellate ganglion block after having tried conservative therapies. The stellate ganglion block provided him with complete pain relief for over five weeks. During a subsequent therapeutic stellate ganglion block, performed by an experienced pain medicine fellow with more than 50 ultrasound guided proceduresclinician, the patient developed a transient injury to the brachial plexus upon needle entry. Subsequent redirection and injection of an ml of injectate resulted in an intravascular injection producing tinnitus. After the tinnitus decreased, he underwent another stellate block using an out of plane approach without any further complications. Two days later, he reported chest and throat discomfort which resolved over the next few days possibly due to a retropharyngeal hematoma. He declined further interventions and was subsequently managed with 3 tablets of oxycodone a day. This report highlights the importance of vigilance and meticulous planning during the performance of ultrasound guided pain interventions.
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spelling pubmed-38211252013-11-15 Transient Neuronal Injury Followed by Intravascular Injection During an Ultrasound Guided Stellate Ganglion Block Shankar, Hariharan Simhan, Swetha Anesth Pain Med Case Report Ultrasound guidance for pain interventions is becoming increasing recognized as a useful imaging tool. One of the common interventions where it is gaining wider acceptance is during the performance of a stellate ganglion block. The following is a unique report where intravascular and neuronal injury occurred during the performance of an ultrasound guided stellate ganglion block followed by dysphagia. 41 year old male, with a diagnosis of complex regional pain syndrome, was referred to our clinic for further management. He underwent a diagnostic ultrasound guided stellate ganglion block after having tried conservative therapies. The stellate ganglion block provided him with complete pain relief for over five weeks. During a subsequent therapeutic stellate ganglion block, performed by an experienced pain medicine fellow with more than 50 ultrasound guided proceduresclinician, the patient developed a transient injury to the brachial plexus upon needle entry. Subsequent redirection and injection of an ml of injectate resulted in an intravascular injection producing tinnitus. After the tinnitus decreased, he underwent another stellate block using an out of plane approach without any further complications. Two days later, he reported chest and throat discomfort which resolved over the next few days possibly due to a retropharyngeal hematoma. He declined further interventions and was subsequently managed with 3 tablets of oxycodone a day. This report highlights the importance of vigilance and meticulous planning during the performance of ultrasound guided pain interventions. Kowsar 2013-01-01 2013 /pmc/articles/PMC3821125/ /pubmed/24244924 http://dx.doi.org/10.5812/aapm.7823 Text en Copyright © 2013, Iranian Society of Regional Anesthesia and Pain Medicine http://creativecommons.org/licenses/by/3/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Shankar, Hariharan
Simhan, Swetha
Transient Neuronal Injury Followed by Intravascular Injection During an Ultrasound Guided Stellate Ganglion Block
title Transient Neuronal Injury Followed by Intravascular Injection During an Ultrasound Guided Stellate Ganglion Block
title_full Transient Neuronal Injury Followed by Intravascular Injection During an Ultrasound Guided Stellate Ganglion Block
title_fullStr Transient Neuronal Injury Followed by Intravascular Injection During an Ultrasound Guided Stellate Ganglion Block
title_full_unstemmed Transient Neuronal Injury Followed by Intravascular Injection During an Ultrasound Guided Stellate Ganglion Block
title_short Transient Neuronal Injury Followed by Intravascular Injection During an Ultrasound Guided Stellate Ganglion Block
title_sort transient neuronal injury followed by intravascular injection during an ultrasound guided stellate ganglion block
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3821125/
https://www.ncbi.nlm.nih.gov/pubmed/24244924
http://dx.doi.org/10.5812/aapm.7823
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