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Comparison of ultrasound-guided stellate ganglion block at 6th and 7th cervical vertebrae using the lateral paracarotid out-of-plane approach for sympathetic blockade in the upper extremity

BACKGROUND: The authors have performed ultrasound-guided stellate ganglion block (SGB) in our clinic using a lateral paracarotid approach at the level of the 6th cervical vertebra (C6). Although SGB at C6 is a convenient and safe method, there are ongoing concerns about the weak effect of sympatheti...

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Autores principales: Baek, Jongyoon, Kim, Bum Soo, Yu, Hwarim, Kim, Hyuckgoo, Lim, Chaeseok, Song, Sun Ok
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Yeungnam University College of Medicine 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6784709/
https://www.ncbi.nlm.nih.gov/pubmed/31620594
http://dx.doi.org/10.12701/yujm.2018.35.2.199
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author Baek, Jongyoon
Kim, Bum Soo
Yu, Hwarim
Kim, Hyuckgoo
Lim, Chaeseok
Song, Sun Ok
author_facet Baek, Jongyoon
Kim, Bum Soo
Yu, Hwarim
Kim, Hyuckgoo
Lim, Chaeseok
Song, Sun Ok
author_sort Baek, Jongyoon
collection PubMed
description BACKGROUND: The authors have performed ultrasound-guided stellate ganglion block (SGB) in our clinic using a lateral paracarotid approach at the level of the 6th cervical vertebra (C6). Although SGB at C6 is a convenient and safe method, there are ongoing concerns about the weak effect of sympathetic blockade in the ipsilateral upper extremity. Therefore, ultrasound-guided SGB was attempted using a lateral paracarotid approach at the level of the 7th cervical vertebra (C7). This prospective study aimed to compare changes in skin temperature after SGB was performed at C6 and C7, and to introduce a lateral paracarotid approach for SGB. METHODS: Thirty patients underwent SGB twice: once at C6 and once at C7. For every SGB, the skin temperature of the patient’s hypothenar area was measured for 15 min at 1-min intervals. Skin temperatures before and after SGB and side effects were compared between C6 and C7 groups. RESULTS: The temperature of the upper extremity increased after SGB was performed at C6 and C7. There were significant differences between mean pre-SGB and the largest increases in post-SGB temperatures (0.50±0.38℃ and 1.41±0.68℃ at C6 and C7, respectively; p<0.05). Significantly increased post-SGB temperatures (difference >1℃) were found in 5/30 (16.7%) and 24/30 (80%) cases for C6 and C7, respectively (p<0.05). There were no significant differences in side effects between SGB performed at C6 or C7 (p>0.05). CONCLUSION: The lateral paracarotid approach using out-of-plane needle insertion for ultrasound-guided SGB performed at C7 was feasible and more effective at elevating skin temperature in the upper extremity than SGB at C6.
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spelling pubmed-67847092019-10-16 Comparison of ultrasound-guided stellate ganglion block at 6th and 7th cervical vertebrae using the lateral paracarotid out-of-plane approach for sympathetic blockade in the upper extremity Baek, Jongyoon Kim, Bum Soo Yu, Hwarim Kim, Hyuckgoo Lim, Chaeseok Song, Sun Ok Yeungnam Univ J Med Original Article BACKGROUND: The authors have performed ultrasound-guided stellate ganglion block (SGB) in our clinic using a lateral paracarotid approach at the level of the 6th cervical vertebra (C6). Although SGB at C6 is a convenient and safe method, there are ongoing concerns about the weak effect of sympathetic blockade in the ipsilateral upper extremity. Therefore, ultrasound-guided SGB was attempted using a lateral paracarotid approach at the level of the 7th cervical vertebra (C7). This prospective study aimed to compare changes in skin temperature after SGB was performed at C6 and C7, and to introduce a lateral paracarotid approach for SGB. METHODS: Thirty patients underwent SGB twice: once at C6 and once at C7. For every SGB, the skin temperature of the patient’s hypothenar area was measured for 15 min at 1-min intervals. Skin temperatures before and after SGB and side effects were compared between C6 and C7 groups. RESULTS: The temperature of the upper extremity increased after SGB was performed at C6 and C7. There were significant differences between mean pre-SGB and the largest increases in post-SGB temperatures (0.50±0.38℃ and 1.41±0.68℃ at C6 and C7, respectively; p<0.05). Significantly increased post-SGB temperatures (difference >1℃) were found in 5/30 (16.7%) and 24/30 (80%) cases for C6 and C7, respectively (p<0.05). There were no significant differences in side effects between SGB performed at C6 or C7 (p>0.05). CONCLUSION: The lateral paracarotid approach using out-of-plane needle insertion for ultrasound-guided SGB performed at C7 was feasible and more effective at elevating skin temperature in the upper extremity than SGB at C6. Yeungnam University College of Medicine 2018-12-31 /pmc/articles/PMC6784709/ /pubmed/31620594 http://dx.doi.org/10.12701/yujm.2018.35.2.199 Text en Copyright © 2018 Yeungnam University College of Medicine This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Baek, Jongyoon
Kim, Bum Soo
Yu, Hwarim
Kim, Hyuckgoo
Lim, Chaeseok
Song, Sun Ok
Comparison of ultrasound-guided stellate ganglion block at 6th and 7th cervical vertebrae using the lateral paracarotid out-of-plane approach for sympathetic blockade in the upper extremity
title Comparison of ultrasound-guided stellate ganglion block at 6th and 7th cervical vertebrae using the lateral paracarotid out-of-plane approach for sympathetic blockade in the upper extremity
title_full Comparison of ultrasound-guided stellate ganglion block at 6th and 7th cervical vertebrae using the lateral paracarotid out-of-plane approach for sympathetic blockade in the upper extremity
title_fullStr Comparison of ultrasound-guided stellate ganglion block at 6th and 7th cervical vertebrae using the lateral paracarotid out-of-plane approach for sympathetic blockade in the upper extremity
title_full_unstemmed Comparison of ultrasound-guided stellate ganglion block at 6th and 7th cervical vertebrae using the lateral paracarotid out-of-plane approach for sympathetic blockade in the upper extremity
title_short Comparison of ultrasound-guided stellate ganglion block at 6th and 7th cervical vertebrae using the lateral paracarotid out-of-plane approach for sympathetic blockade in the upper extremity
title_sort comparison of ultrasound-guided stellate ganglion block at 6th and 7th cervical vertebrae using the lateral paracarotid out-of-plane approach for sympathetic blockade in the upper extremity
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6784709/
https://www.ncbi.nlm.nih.gov/pubmed/31620594
http://dx.doi.org/10.12701/yujm.2018.35.2.199
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