Cervical Sympathetic and Stellate Ganglion Blocks

Elias, Mazin

doi:10.36076/ppj.2000/3/294

Cited by 182 publications

(42 citation statements)

References 26 publications

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“…Therefore, the SGB is a complex sympathetic ganglion block that can be termed a lower cervical sympathetic ganglion block or upper thoracic sympathetic ganglion block. 20…”

Section: Discussionmentioning

confidence: 99%

Effect of botulinum toxin in stellate ganglion for craniofacial hyperhidrosis: a case report

Park

Kim

et al. 2021

J Int Med Res

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Craniofacial hyperhidrosis causes sweating of the face and scalp due to excessive action of the sweat glands and manifests when patients become tense/nervous or develop an elevated body temperature. If noninvasive treatments are ineffective, invasive treatments such as a sympathetic block and resection are considered. A 32-year-old woman with no specific medical history was referred for uncontrolled craniofacial hyperhidrosis that included excessive sweating and hot flushing. Physical examination showed profuse sweating, and infrared thermography showed higher temperature in the neck and face than in the trunk. The patient underwent several stellate ganglion blocks, and her symptoms improved; however, the treatment effect was temporary. Botulinum toxin was then injected into the stellate ganglion. At the time of this writing, her sweating had been reduced for about 6 months and she was continuing to undergo follow-up. Craniofacial hyperhidrosis is a clinical condition in which patients experience excessive sweating of their faces and heads. It is less common than palmar and plantar hyperhidrosis. Botulinum toxin injection into the stellate ganglion is simple and safe and produces longer-lasting effects than other treatments, such as endoscopic sympathectomy and a single nerve block.

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“…Therefore, the SGB is a complex sympathetic ganglion block that can be termed a lower cervical sympathetic ganglion block or upper thoracic sympathetic ganglion block. 20…”

Section: Discussionmentioning

confidence: 99%

Effect of botulinum toxin in stellate ganglion for craniofacial hyperhidrosis: a case report

Park

Kim

et al. 2021

J Int Med Res

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show abstract

“…[24][25][26] Blinded or fluoroscopically guided approaches have been described. 24,27,28 These blinded techniques were expected to have a high risk of inaccurate localization of the targets. A potential risk of vertebral artery puncture and epi-/subdural injection has also been demonstrated.…”

Section: Discussionmentioning

confidence: 99%

MR Imaging of the Superior Cervical Ganglion and Inferior Ganglion of the Vagus Nerve: Structures That Can Mimic Pathologic Retropharyngeal Lymph Nodes

Yokota

Mukai

Hattori

et al. 2017

AJNR Am J Neuroradiol

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“…The sympathetic trunk, extending from the base of the skull to the coccyx, presents bilaterally. It divides into the cervical, thoracic, lumbar and sacral segments [1][2][3].…”

Section: Introductionmentioning

confidence: 99%

Incidence of inadvertent intercostal or epidural spread during thoracic sympathetic ganglion block

Hong

Kim

2020

Anesth Pain Med

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Background: Sympathetic blocks (SBs) have been used widely to relieve the symptoms of sympathetically maintained pain (SMP). The thoracic sympathetic ganglion is not separated from somatic nerves by muscles and connective tissue. The upper thoracic ganglion runs along the posterior surface of the vertebral column in close proximity to the adjacent epidural region. This anatomical difference leads to frequent epidural and intercostal spread in cases of thoracic SBs. The purpose of this study was to investigate the incidence of inadvertent intercostal and epidural injections during thoracic SBs.Methods: Twenty-two patients who were suffering from complex regional pain syndrome or lymphedema after breast cancer surgery were managed with two or three times of thoracic SBs. Therefore, injections of 63 thoracic SBs from 22 patients were enrolled in this study. An investigator who did not attend the procedure evaluated the occurrence of intercostal or epidural spread using anteroposterior fluoroscopic images.Results: The overall incidence of inadvertent intercostal or epidural spread of contrast was 47.5%. Among the inadvertent injections, intercostal spread (34.9%) was more frequent than epidural spread (12.6%). Only 52.5% of the thoracic SBs demonstrated successful contrast spread without any inadvertent spread. The mean difference in skin temperature between the blocked and unblocked sides was 2.5 ± 1.8ºC. Fifty-nine (93.6%) injections demonstrated more than 1.5ºC difference.Conclusions: Thoracic SBs showed a high incidence (47.5%) of inadvertent epidural or intercostal injection. Thus, special attention is required for the diagnosis of SMP or the injection of any neurolytic agent around sympathetic ganglion.

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Cervical Sympathetic and Stellate Ganglion Blocks

Cited by 182 publications

References 26 publications

Effect of botulinum toxin in stellate ganglion for craniofacial hyperhidrosis: a case report

Effect of botulinum toxin in stellate ganglion for craniofacial hyperhidrosis: a case report

MR Imaging of the Superior Cervical Ganglion and Inferior Ganglion of the Vagus Nerve: Structures That Can Mimic Pathologic Retropharyngeal Lymph Nodes

Incidence of inadvertent intercostal or epidural spread during thoracic sympathetic ganglion block

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