• The Korean Journal of Pain
• /
• 제14권2호
• /
• pp.239-244
• /
• 2001

Stellate ganglion block (SGB) is a frequently used sympathetic block utilized to diagnose or treat various painful conditions of the cervical regions and the upper extremities. Additionally, RadioFrequency (RF) lesions of the stellate ganglion can be useful in managing sympathetically-maintained pain. Two patients were suffering from pain in the face, neck and the upper extremities were treated with stellate ganglion block. In spite of repeated blocks, the degree and duration of pain did not decrease. However, after performing radiofrequency thermocoagulation of the stellate ganglion under fluroscopy, followed by thermography on the process of treatment with RF stellate ganglion neurolysis, the patients' pain levels were alleviated after the RF lesions of stellate ganglion and the procedure also increased the temperature at the upper extremity on thermogarphy. Additionally, the patients did not complain of any remarkable complications following this procedure.

• The Korean Journal of Pain
• /
• 제8권2호
• /
• pp.312-318
• /
• 1995

Stellate ganglion block is extensively performed in pain closing to treat a diversity of diseases. Stellate ganglion phenol neurolysis, however, has not been not popular because of risk and complications such as: permanent horner's syndrome, hoarseness, pneumothorax and intravascular or intraspinal injection. But Racz recently performed stellate ganglion phenol neurolysis successfully, under fluoroscopic guide, minus significant complication. Three patients were recently treated at our pain clinic by repeated stellate ganglion block with local anesthetics. Patients showed immediate signs of improvement but prolonged pain relief was not achieved. Therefore we reported to performing stellate ganglion phenol neurolysis following Racz's technique. We successfully treated: two cases of reflex sympathetic dystrophy of the upper extremity, and a case of postherpetic neuralgia of jaw, neck and upper chest wall, by stellate ganglion phenol neurolysis, devoid of any significant complications.

• The Korean Journal of Pain
• /
• 제12권1호
• /
• pp.128-131
• /
• 1999

Stellate ganglion block is a well established method for the management of certain pain syndromes (e.g., chronic regional pain syndrome, facial pain) in the cervicothoracic region and upper extremity. The stellate ganglion resides between the C7 transverse process and the head of the first rib. Anesthetic injections for the stellate ganglion block are typically made at the level of the transverse process of either the C6 or C7 vertebrae to avoid the pleura, vessels, and nerve roots. Method of positioning the needle tip directly at the ganglion has been described, but are problematic because of the risk of injury to or injection into adjacent structures. It is necessary to know the exact anatomic position of the stellate ganglion when permanent blockade is required by means of radiofrequency thermocoagulation. Whereas fluroscopy shows only bony feature, computerized tomography also images nerves, vessels, and lung, allowing accruate needle placement. We report a case of the percutaneous radiofrequency thermocoagulation of the stellate ganglion after computerized tomography-guided localization.

• The Korean Journal of Pain
• /
• 제11권1호
• /
• pp.109-112
• /
• 1998

The sympathetic nervous system has been implicated as an important factor contributing to causalgia. Basis on reports of presence of opioid receptors in sympathetic autonomic ganglia, including human stellate ganglion, we administered morphine in stellate ganglion block for a patient with causalgia. The patient suffering from brachial plexus injury treated with stellate ganglion block in conjunction with physical therapy. Stellate ganglion block was performed in a paratracheal approach by injection of 1% lidocaine, or 0.25% bupivacaine 8 ml, with morpine 1 mg. Patient's symptoms were dramatically improved after 13 stellate ganglion blocks.

• The Korean Journal of Pain
• /
• 제8권2호
• /
• pp.331-335
• /
• 1995

Asthma is a disease of the airways that is characterized by increased responsiveness of the tracheobronchial tree to a multiplicity of stimuli. A number of causes have been postulated for the increased airway reactivity of asthma is conservative as beta-adrenergic agonist, methylxanthines, glucocorticoids, anticholinergics and mast cell stabilizing agent. Stellate ganglion block for the treatment of bronchial asthma has its controversies. Stellate ganglion block was performed for the treatment of 3 patients with bronchial asthma. After stellate ganglion blocks, dyspnea, coughing and wheezing was markedly reduced. Lung function test improved with 1 st case. Two asthma cases were able to discontinue medication for asthma. No severe aggrevation of bronchial symptoms were noted after stellate ganglion blocks. It suggested that stellate ganglion block can be safely performed on bronchial asthmatic patients.

• The Korean Journal of Pain
• /
• 제6권2호
• /
• pp.204-207
• /
• 1993

본 통증치료실에서는 알러지성비염, 과민성대장증후군, 고혈압, 불면증, 만성변비환자를 대상으로 하루에 1회씩 총 15회의 성상신경정차단요법을 시행하였는바 총 13명중 5명에서 우수, 6명에서 양호, 3명에서 무효하였다.

• The Korean Journal of Pain
• /
• 제9권2호
• /
• pp.336-339
• /
• 1996

Stellate ganglion block which usually practiced in pain clinics may combined with hemodynamic changes because it blocks sympathetic nerve chains. We measured the hemodynamic changes with NCCOM3-$R7^{(R)}$ (BOMED, U.S.A.) which applicated bioimpedance method in twenty-two patients. Mean arterial pressure, heart rate, cardiac output, ejection fraction and left ventricle end diastolic volume (LEDV) were measured before stellate ganglion block (control), 1, 3, 5, 10 and 20 minutes after stellate ganglion block with 8 ml of 0.25% bupivacaine. The results were as follows: Mean arterial pressure decreased significantly (p<0.05) in 10, 20 minutes after stellate ganglion block comparing to control, but not clinically significant. Heart rate, cardiac output, ejection fraction and LVEDV showed no significant change compared to control value. These results showed that stellate ganglion block is a safe technique without significant hemodynamic changes.

• The Korean Journal of Pain
• /
• 제11권2호
• /
• pp.299-301
• /
• 1998

Stellate ganglion block is frequently effective on the pain of head and upper extremities. However, if the degree and duration of pain relief does not increase with repeated blocks, we may consider the neurolytic procedure on the stellate ganglion. A patient sufferring from the pain in the region of ophthalmic branch of left trigeminal nerve and left eyeball region had been treated with stellate ganglion block. In spite of repeated blocks, the degree and duration of pain relief did not increase. We performed the radiofrequency thermocoagulation of stellate ganglion at the operation room under fluoroscopy. Patient got pain relief immediately after the procedure without any remarkable complication except a mild ptosis, which was shown before the procedure. We may give priority to radiofrequency thermocoagulation for stellate ganglion neurolysis due to its simplicity and safty.

• The Korean Journal of Pain
• /
• 제11권2호
• /
• pp.346-349
• /
• 1998

The technique of the stellate ganglion block is widely used as it is relatively simple and safe. But it can cause severe complications because there are major blood vessels and nerves around the stellate ganglion. We practiced CPR because of the respiratory failure caused by severe hematoma in the neck following the stellate ganglion block. A 46-year-old male patient admitted to ENT department because of the both sudden sensorineural hearing loss that happened after URI. He was referred to Pain Clinic for further evaluation and treatment. We decided to block the stellate ganglion. We injected 6ml of 0.5% mepivacaine on both sides of the stellate ganglion. There were no blood aspiration and abnormal vital signs during the 30 minute observation, either. Three hours after he went to the private room, he had pain and edema in his neck, but no respiratory defficulty. But later, respiratory failure was suddenly followed. So we practiced CPR. We confirmed severe hematomas in the neck through CT scanning. Hematomas is removed and the ruptured blood vessels which is supposed to be muscular branch of vertebral artery is ligated under general anesthesia. The patient was discharged from hospital after the treatment of pneumonia and duodenal ulcer as complications. We recommand you to compress the block site more than five minutes and not to prick with the needle several times at one point to prevent the formation of hematomas.

• The Korean Journal of Pain
• /
• 제8권1호
• /
• pp.120-123
• /
• 1995

편두통은 기전이 불분명하나 각종 신경전달물질이 작용하여 국소적인 혈관수축과 혈관확장을 일으킨다. 성상신경절차단은 뇌혈류의 증가, 신체항상성개선, 교감신경기능의 둔화등의 효과로 편두통의 치료에 있어서 의의를 갖는다고 사료된다. 그러나 아직 기전이 불분명하므로 이에 대한 더 많은 연구가 필요하다고 본다.