OBJECTIVE: To compare the efficacy of ultrasonography guided stellate ganglion block (US-SGB) with that of blind SGB in management of the stroke patients with complex regional pain syndrome (CRPS) type 1. METHOD: Forty-two patients with post-stroke CRPS were randomly assigned to either US-guided SGB (22 patients) or blind SGB group (20 patients). The mean age of US-guided SGB and blind SGB groups was 61.3+/-5.6 years and 59.1+/-4.5 years. We performed two blockades at 7-day intervals on the affected side of patients with CRPS. Pain intensity, using a visual analog score (VAS), score of CRPS clinical severity, and the amounts of affected hand swelling with a hand volumeter were assessed before, 2 weeks and 4 weeks after treatment. RESULTS: In both groups, VAS and the amount of hand swelling were significantly decreased after 2 weeks and after 4 weeks. Between two groups, VAS difference of US-guided SGB group and that of blind SGB group were 2.61+/-1.09, 1.88+/-0.62 at 2 weeks and 3.67+/-1.03, 3.13+/-0.62 at 4 weeks, respectively. US-guided SGB group showed more significant improvement in mean change of VAS compared to the blind SGB group (p-value<0.05). CONCLUSION: Both US-guided SGB and blind SGB techniques were effective in relieving pain in subacute stroke patients with CRPS. US-guided SGB was better in pain relief but has no advantages in reduction of hand swelling in this study.
Hand ; Humans ; Stellate Ganglion ; Stroke

No abstract available.
Hearing Loss, Sensorineural* ; Stellate Ganglion*

BACKGROUND: To obtain optimal results with stellate ganglion block, it is necessary to have a precise knowledge of the exact location of the stellate ganglion and its relationship to the upper thoracic and lower cervical ganglia, in the procedure, the landmark is C6 transverse process, and the drugs for sympathetic block is injected into it. METHODS: We attempted to show the correlation between the height and the distance from C6 transverse process to stellate ganglion and T2 sympathetic ganglion, and respective means and standard deviations in 10 cadavers to estimate whether the height can be used as one of the factors to decide injection dosage for stellate ganglion block, or not. RESULTS: The mean of height was 161.20 5.89 cm and the mean of the distance from left C6 transverse process to T2 sympathetic ganglion was 44.88 6.76, the mean of the distance from right C6 transverse process to stellate ganglion was 40.73 7.47 mm, and the correlation coefficient and regression equation were 0.29 and y=0.38 20.55, respectively, the mean of the distance from left C6 transverse process to T2 sympathetic ganglion was 65.02 11.12 mm, and the correlation coefficient and regression equation were 0.75 and y=1.42 164.01, respectively, the mean of the distance from right C6 transverse process to T2 sympathetic ganglion was 61.38 9.20 mm, and the correlation coefficient and regression equation were 0.74 and y=1.16 125.88, respectively. CONCLUSIONS: It is concluded that we can used the height as one of effective factors to decide drug dosage for stellate ganglion block in Korean.
Cadaver ; Ganglia ; Ganglia, Sympathetic* ; Stellate Ganglion*

BACKGROUND: Anosmia can be frustrating for both the patient and physician, with no clear treatment. We prospectively investigated the effects of stellate ganglion block (SGB) in anosmic patients who were unresponsive to conventional steroid therapy. METHODS: Thirteen patients with anosmia were treated with SGB. To evaluate the improvement in olfactory function, we evaluated both changes in subjective symptoms and the butanol threshold test. The number of SGB required for improvement in olfactory function was counted. RESULTS: Seven patients (54%) showed improvement of olfactory function with SGB. The average number of SGB for the first response was 7.4 +/- 5.9 times. CONCLUSIONS: These results suggest that SGB may be a good treatment modality for patients with anosmia unresponsive to steroid therapy.
Humans ; Olfaction Disorders* ; Prospective Studies ; Stellate Ganglion*

OBJECTIVE: To evaluate the effects of stellate ganglion block(SGB) in adhesive capsulitis of the shoulder which was not treated with other procedures and therapeutic exercise. METHOD: Fifty patients with adhesive capsulitis of the shoulder were assessed by the shoulder range of motion(ROM) and visual analogue scale before and in 30 minutes after the SGB without other procedures and therapeutic exercise. RESULTS: In 30 minute after the SGB, the shoulder ROM increased 11degrees in flexion, 14degrees in abduction, 8degrees in internal rotation, and 6degrees in external rotation and visual analogue scale decreased (P<0.05). The changes of shoulder ROM after the SGB were not significantly related to duration of the adhesive capsulitis of shoulder, except in flexion. CONCLUSION: The stellate ganglion block can be another effective method for the patients with adhesive capsulitis of the shoulder.
Adhesives* ; Bursitis* ; Humans ; Shoulder* ; Stellate Ganglion*

Ultrasound has emerged to become a commonly used modality in the performance of chronic pain interventions. It allows direct visualization of tissue structure while allowing real time guidance of needle placement and medication administration. Ultrasound is a relatively affordable imaging tool and does not subject the practitioner or patient to radiation exposure. This review focuses on the anatomy and sonoanatomy of peripheral non-axial structures commonly involved in chronic pain conditions including the stellate ganglion, suprascapular, ilioinguinal, iliohypogastric, genitofemoral and lateral femoral cutaneous nerves. Additionally, the review discusses ultrasound guided intervention techniques applicable to these structures.
Chronic Pain ; Humans ; Needles ; Peripheral Nerves ; Stellate Ganglion

Atypical facial pain (AFP) is a type of facial pain which does not fulfill any other diagnosis. It has several features such as no objective signs, no obvious explanation of the cause and poor response to treatments. We report a case of a female patient with AFP on the left maxillary area. The pain was increased by cold innocuous stimulation and thermography showed that the temperature on the painful area was significantly decreased. The pain was successfully alleviated by stellate ganglion block (SGB). Therefore, SGB can be effectively used to treat AFP.
Diagnosis ; Facial Pain* ; Female ; Humans ; Stellate Ganglion* ; Thermography

BACKGROUND: The effect of the unilateral stellate ganglion block (SGB) on cardiovascular regulation remains controversial. We wished to evaluate the changes in heart rate variability (HRV) after a unilateral stellate ganglion block in patients with head and neck pain in the present study. METHODS: Patients with head and neck pain (n = 89) were studied. HRV was determined before and after a C6 unilateral stellate ganglion block (right-sided SGB, 40; left-sided SGB, 49) using a paratracheal technique with 1% mepivacaine (6 ml). RESULTS: There were no significant differences in HRV indices before and after right-sided SGB. The log scale of power in the high frequency range (lnHF) was increased and ratio of power in the low frequency range (LF) to power in the high frequency range (HF) ratio was decreased after left-sided SGB. CONCLUSIONS: These results demonstrated that left-sided SGB increased parasympathetic activities in patients with head and neck pain.
Head ; Heart ; Heart Rate ; Humans ; Mepivacaine ; Neck Pain ; Stellate Ganglion

BACKGROUND AND OBJECTIVES: Viral and vascular disorders are considered to be a major cause of idiopathic sudden sensorineural hearing loss (ISSNHL). Lipoprostaglandin E₁ (lipo-PGE₁) has vasodilating activity and has been used to treat ISSNHL. The purpose of this study was to determine the specific therapeutic effects of lipo-PGE₁ and compare them to other treatment modalities for ISSNHL. SUBJECTS AND METHODS: The study group had 1,052 patients diagnosed with ISSNHL. All were treated with steroid, carbogen inhalation, stellate ganglion block (SGB), or PGE₁. The CP group (steroid, carbogen inhalation, and PGE1 injection; 288 patients) was treated with lipo-PGE₁ and carbogen inhalation, the CS group (steroid, carbogen inhalation, and stellate ganglion block; 232 patients) with steroid, carbogen inhalation, and SGB, the C group (steroid and carbogen inhalation; 284 patients) with steroid and carbogen, and the control group (steroid only; 248 patients) with steroid only. Patients in the groups receiving lipo-PGE₁ received a continuous infusion of 10 µL lipo-PGE₁. RESULTS: The overall recovery rate after treatment was 52.2%, and recovery rates by group were 67.7% in the CP group, 54.3% in the CS group, 52.1% in the C group, and 32.2% in the control group. Therefore, the therapeutic results in groups treated with lipo-PGE₁ were better than results in other groups. The difference was statistically significant. CONCLUSIONS: The study results suggested that the CP group received effective treatment modalities for ISSNHL. The combined therapy of lipo-PGE₁ with carbogen inhalation in patients with ISSNHL was more beneficial than other treatment modalities.
Alprostadil ; Hearing Loss, Sensorineural* ; Humans ; Inhalation ; Stellate Ganglion ; Therapeutic Uses*

Stellate ganglion block, due to its wide range of indications, is the most widely practiced procedure in pain clinics. We experienced the case of a 44-year-old female patient who developed prolonged Horner's syndrome after the use of stellate ganglion block. The patient recovered spontaneously from the Horner's syndrome after 12 months. If Horner's syndrome should occur, its etiology will need to be assessed. It is also important to assure the patient they will recover from the complication within a year.
Adult ; Female ; Horner Syndrome* ; Humans ; Pain Clinics ; Stellate Ganglion*