The optimal volume of 0.2% ropivacaine required for an ultrasound-guided stellate ganglion block.
10.4097/kjae.2011.60.3.179
- Author:
Gul JUNG
1
;
Bum Soo KIM
;
Kyung Bae SHIN
;
Ki Bum PARK
;
Sae Yeon KIM
;
Sun Ok SONG
Author Information
1. Department of Anesthesiology and Pain Medicine, College of Medicine, Yeungnam University, Daegu, Korea. sosong@med.yu.ac.kr
- Publication Type:Original Article
- Keywords:
Local anesthetics;
Stellate ganglion block;
Ultrasound;
Volume
- MeSH:
Amides;
Anesthetics, Local;
Fascia;
Female;
Head;
Hearing Loss;
Horner Syndrome;
Humans;
Male;
Muscles;
Neck;
Needles;
Stellate Ganglion
- From:Korean Journal of Anesthesiology
2011;60(3):179-184
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: This study was performed to find the optimal volume of local anesthetics needed for a successful ultrasound-guided stellate ganglion block (SGB) to treat head and neck pathology. METHODS: Fifteen female and fourteen male sensory-neural hearing loss patients received 4 times SGBs with 0.2% ropivacaine in volumes of 6, 4, 3 and 2 ml at 1 to 3 day intervals. Using the transverse short-axis view of the neck that showed Chassaignac's tubercle at the C6 level, a 25-gauge, and 4 cm needle was inserted via the lateral paracarotid approach with out-of-plane targeting between the prevertebral fascia and the ventral surface of longus colli muscle (subfascial injection). A successful block was confirmed with the onset of ptosis (Horner's syndrome). RESULTS: There were no significant statistical differences between the presence of Horner's syndrome and the volume of local anesthetics given. However, Horner's syndrome was present in all trials for the 4 ml and 6 ml groups. Six (20.7%) and three out (10.4%) of twenty-nine trials in the 2 ml and 3 ml groups, respectively, failed to elicit Horner's syndrome. The duration of action was significantly different in the 2 ml group compared to that of the 6 ml group, but there was no significant difference between the other groups, including the 4 ml vs. 6 ml groups. The side effects were not different between the groups. CONCLUSIONS: This data suggests that the optimal volume of 0.2% ropivacaine for ultrasound-guided SGB to treat the head and neck pathology in daily practice is 4 ml.
