성상신경절 차단술과 상완신경총 차단술이 상지 피부온에 미치는 영향

Effect of the Brachial Plexus Block and Stellate Ganglion Block on Skin Temperature of the Upper Extremity

Background: In our hospital, stellate ganglion block(SGB) has been performed for the prevention and treatment of vasospasm after microscopic reimplantation of finger(s). If brachial plexus block(BPB) has the same effect of sympathetic block on the upper extremity as SGB, it may be preferable to the SGB because it povides postoperative analgesia and is administered continuously. So we measured and compared the change of skin temperature on the forearm as the parameter of sympathetic blockade after SGB and BPB. Methods: The forty-two patients, belonged to ASA class 1~2, were received BPB for hand surgery. The skin temperature was measured before and after BPB on the forearm with patient monitor(LN 6199, YSI 400 Series Temperature Probe, Hellige, Germany). After 24 hours, ipsilateral SGB was performed and skin temperature was recorded before and after SGB. Results: The increase of skin temperature after procedures was $1.1{\pm}0.5^{\circ}C$(from $34.5{\pm}0.7^{\circ}C$ to $35.6{\pm}0.5^{\circ}C$) in BPB and $0.6{\pm}0.3^{\circ}C$(from $34.9{\pm}0.5^{\circ}C$ to $35.5{\pm}0.5^{\circ}C$) in SGB. The changes of skin temperature in both blocks were statistically significant(p<0.01), and the skin temperatures after each procedure were revealed no significant difference(p$\simeq$0.62). Conclusion: We thought that BPB produced sympathetic blockade on the upper extremity as much as SGB. Moreover, it provides postoperative pain relief and may be employed as continuous BPB could be used for hand surgery with many advantages.