Objectives: This study sought to describe our institutional experience of repeated percutaneous stellate ganglion blockade (R-SGB) as a treatment option for drug-refractory electrical storm in patients with nonischemic cardiomyopathy (NICM). Methods: This prospective observational study included 8 consecutive NICM patients who had drug-refractory electrical storm and underwent R-SGB between June 1, 2021 and January 31, 2022. Lidocaine (5 ml, 1%) was injected in the vicinity of the left stellate ganglion under the guidance of ultrasound, once per day for 7 days. Data including clinical characteristics, immediate and long-term outcomes, and procedure related complications were collected. Results: The mean age was (51.5±13.6) years. All patients were male. 5 patients were diagnosed as dilated cardiomyopathy, 2 patients as arrhythmogenic right ventricular cardiomyopathy and 1 patient as hypertrophic cardiomyopathy. The left ventricular ejection fraction was 37.8%±6.6%. After the treatment of R-SGB, 6 (75%) patients were free of electrical storm. 24 hours Holter monitoring showed significant reduction in ventricular tachycardia (VT) episodes from 43.0 (13.3, 276.3) to 1.0 (0.3, 34.0) on the first day following R-SGB (P<0.05) and 0.5 (0.0, 19.3) after whole R-SGB process (P<0.05). There were no procedure-related major complications. The mean follow-up was (4.8±1.1) months, and the median time of recurrent VT was 2 months. Conclusion: Minimally invasive R-SGB is a safe and effective method to treat electrical storm in patients with NICM.
Humans ; Male ; Adult ; Middle Aged ; Aged ; Female ; Stroke Volume ; Stellate Ganglion/surgery* ; Ventricular Function, Left ; Cardiomyopathies/complications* ; Tachycardia, Ventricular/therapy* ; Treatment Outcome ; Catheter Ablation

OBJECTIVE: To explore the effects of ultrasound-guided stellate ganglion block (SGB) on perioperative stress response, gastrointestinal hormones and postoperative gastrointestinal function recovery in patients undergoing laparoscopic radical gastrectomy for gastric cancer. METHODS: This study was conducted among 60 American Society of Anesthesiologists (ASA) class II-III patients with gastric cancer (regardless of gender, aged 35-75 years with BMI of 18.5-26 kg/m²) undergoing elective laparoscopic radical gastrectomy. The patients were randomized into experimental group (S group, n=30) and control group (NS group, n=30). In S group, SGB at the C₆ level of the right cervical spine was performed under ultrasound guidance 15 min before induction of anesthesia by injection of 7 mL 0.5% ropivacaine; the patients in NS group received injections of normal saline in the same manner. Peripheral venous blood samples were collected before SGB (T1), after surgery (T2), and on the 2nd and 6th days after surgery (T3 and T4) for determination of the levels of motitin (MOT), vasoactive intestinal peptide (VIP), cortisol (COR), and blood glucose (GLU). Intraoperative usage of sufentanil, recovery rate of intestinal sounds at 36, 48, 60, 72, 84 and 96 h after operation and the time of first passage of flatus were recorded and compared between the two groups. RESULTS: There was no significant difference in the total amount of sufentanil consumption between the two groups. Compared with those in NS group, the patients in S group had significant lower COR and VIP levels (P < 0.05) and higher MOT level (P < 0.05) at T2, T3 and T4. Glu level at T2 and T3 was also significantly lower in S group (P < 0.05). The recovery rates of intestinal sounds at 36, 48, 60, 72 and 84 h after surgery were significantly higher (P < 0.05) and the time of the first passage of flatus was earlier in S group than in NS group (P < 0.05). CONCLUSION In patients with gastric cancer undergoing laparoscopic radical gastrectomy, ultrasound-guided SGB can reduce postoperative stress level, promote the recovery of gastrointestinal hormone secretion, and accelerate postoperative recovery of gastrointestinal functions.
Adult ; Aged ; Gastrectomy ; Humans ; Laparoscopy ; Middle Aged ; Recovery of Function ; Stellate Ganglion ; Stomach Neoplasms/surgery* ; Ultrasonography, Interventional

BACKGROUND: A stellate ganglion block (SGB) causes increased blood flow in the maxillofacial region, exhibiting the potential for regenerative effects in damaged tissue. The focus of this study was to understand the efficacy of SGB for regenerative effects against nerve damage. A rat model of the superior cervical ganglion block (SCGB) was created instead of SGB, and facial blood flow, as well as sympathetic nervous system function, were measured. METHODS: A vertical incision was made on the left side of the neck of a Wistar rat, and a 5-mm resection of the superior cervical ganglion was performed at the back of the bifurcation of the internal and external branches of the left common carotid artery. Blood flow in the skin at the mandibular angle and mean facial temperature were measured using a laser-Doppler blood flow meter and a thermographic camera, respectively, over a 5-week period after the block. In addition, the degree of ptosis and miosis were assessed over a period of 6 months. RESULTS: The SCGB rat showed significantly higher blood flow at the mandibular angle on the block side (P < 0.05) for 3 weeks, and significantly higher skin temperature (P < 0.05) for 1 week after the block. In the SCGB rat, ptosis and miosis occurred immediately after the block, and persisted even 6 months later. CONCLUSIONS: SCGB in rats can cause an increase in the blood flow that persists over 3 weeks.
Animals ; Carotid Artery, Common ; Horner Syndrome ; Miosis ; Models, Animal ; Neck ; Rats ; Regional Blood Flow ; Skin ; Skin Temperature ; Stellate Ganglion ; Superior Cervical Ganglion ; Sympathetic Nervous System ; Thermography

OBJECTIVETo compare the efficacy differences between catgut implantation at stellate ganglion combined with oral administration of alendronate sodium and oral administration of alendronate sodium alone on postmenopausal osteoporosis (PO).

METHODSSixty patients of PO were randomly divided into an observation group and a control group, 30 cases in each one. The patients in the control group were treated with oral administration of alendronate sodium. Based on the treatment of control group, the patients in the observation group were treated with catgut implantation at stellate ganglion. The treatment was given once a week in the two groups; the consecution treatment of four weeks constituted one session, and totally six sessions were given. The changes of total syndrome score, bone mineral density of lumbar vertebra (L to L) and femeral neck (FN) and estradiol were observed before and after treatment; the clinical efficacy was compared between the two groups.

RESULTSCompared before treatment, the total syndrome score, bone mineral density of lumbar vertebra (L to L) and FN and estradiol were significantly improved after treatment (all <0.05); which were more significant in the observation group (all <0.05). Compared before treatment, the level of estradiol in the control group was not significantly changed after treatment (>0.05), while that in the observation group was significantly changed after treatment (<0.05). After treatment, the level of estradiol in the observation group was higher than that in the control group (<0.05). The total effective rate was 93.3% (28/30) in the observation group, which was significantly higher than 83.3% (25/30) in the control group (<0.05).

CONCLUSIONCatgut implantation at stellate ganglion combined with oral administration of alendronate sodium are superior to oral administration of alendronate sodium alone for postmenopausal osteoporosis, which improve the clinical symptoms, regulate the hormone level and increase bone mineral density.

Acupuncture Therapy ; Alendronate ; administration & dosage ; Bone Density ; Catgut ; Female ; Humans ; Osteoporosis, Postmenopausal ; therapy ; Stellate Ganglion

Breast cancer related lymphedema (BCRL) is one of the most intractable complications after surgery. Patients suffer from physical impairment, as well as psychological depression. Moreover, a recent study revealed that cellulitis significantly increased the risk of BCRL, and cellulitis has been suggested as a risk factor of BCRL development. We describe a patient treated with stellate ganglion blocks (SGBs) without steroid for relief of symptoms and reduction of the arm circumference of breast cancer-related infectious lymphedema in a month. We measured the arm circumference at four locations; 10 cm and 5 cm above and below the elbow crease, numeric rating scale (NRS) score, lymphedema and breast cancer questionnaire (LBCQ) score on every visit to the pain clinic. A serial decrease of the arm circumference and pain score were observed after second injection. In the middle of the process, cellulitis recurred, we performed successive SGBs to treat infectious lymphedema. The patient was satisfied with the relieved pain and swelling, especially with improved shoulder range of motion as it contributes to better quality of life. This case describes the effects of SGB for infectious BCRL patients. SGB could be an alternative or ancillary treatment for infectious BCRL patients.
Arm ; Breast Neoplasms ; Breast* ; Cellulitis ; Depression ; Elbow ; Humans ; Lymphedema* ; Pain Clinics ; Quality of Life ; Range of Motion, Articular ; Risk Factors ; Shoulder ; Stellate Ganglion*

The Stellate ganglion block (SGB) could be used to treat sympathetic dependent circulatory insufficiency. We report a 36-year-old female patient with burn-induced refractory ischemic ulcer in distal phalanges. The patient admitted in department of plastic surgery for second degree burn wound in the right second through fifth fingertips. Continuous dressing treatment was conducted. However digital burn wounds were not healed but seems to be refractory. The upper extremity angiography revealed decreased perfusion and the fingertip wounds were diagnosed as ischemic ulcer. Despite of botulinum toxin injection into the perineural tissue and aspirin prescription, burn wounds showed ulcerative necrotic change. The SGBs were performed twice a week for 3 weeks to restore vasoconstriction of the upper extremity arteries. The follow-up angiography showed significant improvement of fingertip perfusion. Consequently, wounds were completely healed. In conclusion, SGB could be a rational option to overcome burn-induced digital ischemia refractory to other medical therapy.
Adult ; Angiography ; Arteries ; Aspirin ; Bandages ; Botulinum Toxins ; Burns ; Female ; Follow-Up Studies ; Humans ; Ischemia ; Perfusion ; Prescriptions ; Stellate Ganglion ; Surgery, Plastic ; Ulcer ; Upper Extremity ; Vasoconstriction ; Wounds and Injuries

OBJECTIVE: For patients who do not relieve with pharmacological intervention, interventional treatment including neurolytic blocks may have a specific role in palliative cancer management.METHOD: We performed cervical stellate ganglion block for the second time with Botulinum toxin type A mixed with 4 ml of normal saline, total 75 IU of Botulinum toxin type A, minimal effective dosage was measured to minimize the possible side effects.RESULTS: About 3 days later, the patient reported that her continuous pain intensity had decreased from 8/10 to 4/10 on the visual analogue scale score. The frequency of the pain attack that required additional morphine injections was also decreased. As a result, her maximum morphine requirement dose per day was significantly reduced.CONCLUSION: In this case, cervical stellate ganglion block with Botulinum toxin hadlonger lasting effect in the continuous pain intensity and resulted in less frequent pain attack. Botulinum toxin can be a possibleintervention material in intractable neuropathic pain related to cancer.
Botulinum Toxins ; Botulinum Toxins, Type A ; Humans ; Methods ; Morphine ; Neuralgia ; Stellate Ganglion

Syncope is defined as a transient loss of consciousness and postural tone, characterized by rapid onset, short duration, and spontaneous recovery. Stellate ganglion block (SGB) is a nerve block method that is used for treatment of neuropathic pain in the head, neck and upper extremities, especially trigeminal neuralgia, postherpetic neuralgia and complex regional pain syndrome. SGB can modulate and stabilize the sympathetic nervous system, which prevents it from overexcitation and improves symptoms of syncope. The authors report a patient who was treated for pain and edema of both upper extremities with SGB, then showed improvement in recurrent syncope followed by chest pain and overall quality of life.
Chest Pain ; Edema ; Head ; Humans ; Methods ; Neck ; Nerve Block ; Neuralgia ; Neuralgia, Postherpetic ; Quality of Life ; Stellate Ganglion ; Sympathetic Nervous System ; Syncope ; Thorax ; Trigeminal Neuralgia ; Unconsciousness ; Upper Extremity

BACKGROUND: The authors have performed ultrasound-guided stellate ganglion block (SGB) in our clinic using a lateral paracarotid approach at the level of the 6th cervical vertebra (C6). Although SGB at C6 is a convenient and safe method, there are ongoing concerns about the weak effect of sympathetic blockade in the ipsilateral upper extremity. Therefore, ultrasound-guided SGB was attempted using a lateral paracarotid approach at the level of the 7th cervical vertebra (C7). This prospective study aimed to compare changes in skin temperature after SGB was performed at C6 and C7, and to introduce a lateral paracarotid approach for SGB.METHODS: Thirty patients underwent SGB twice: once at C6 and once at C7. For every SGB, the skin temperature of the patient's hypothenar area was measured for 15 min at 1-min intervals. Skin temperatures before and after SGB and side effects were compared between C6 and C7 groups.RESULTS: The temperature of the upper extremity increased after SGB was performed at C6 and C7. There were significant differences between mean pre-SGB and the largest increases in post-SGB temperatures (0.50±0.38℃ and 1.41±0.68℃ at C6 and C7, respectively; p < 0.05). Significantly increased post-SGB temperatures (difference >1℃) were found in 5/30 (16.7%) and 24/30 (80%) cases for C6 and C7, respectively (p < 0.05). There were no significant differences in side effects between SGB performed at C6 or C7 (p>0.05).CONCLUSION: The lateral paracarotid approach using out-of-plane needle insertion for ultrasound-guided SGB performed at C7 was feasible and more effective at elevating skin temperature in the upper extremity than SGB at C6.
Autonomic Nerve Block ; Cervical Vertebrae ; Female ; Humans ; Methods ; Needles ; Prospective Studies ; Skin Temperature ; Spine ; Stellate Ganglion ; Ultrasonography ; Upper Extremity

Hiccups are an involuntary contraction of the diaphragm that may repeat several times per minute. In general, hiccups are very common, transient, and self-limited. However, if the condition persists longer than days or months, it impacts a patient's quality of life. Pharmacologic and non-pharmacologic methods are used for the treatment of persistent or intractable hiccups. Nerve block and stimulation have been shown to be effective through neural pathway interruption or stimulation of the hiccup reflex arc. Stellate ganglion block (SGB) is an injection of local anesthetic adjacent to a group of nerves in the neck known as the stellate ganglion. The authors report a case of SGB as an effective treatment for a patient with intractable hiccups resulting from right lateral medullary syndrome.
Diaphragm ; Hiccup* ; Humans ; Lateral Medullary Syndrome ; Neck ; Nerve Block ; Neural Pathways ; Quality of Life ; Reflex ; Stellate Ganglion* ; Sympathetic Nervous System