Efficacy of Oblique Fluoroscopic Approach for Stellate Ganglion Block

Abstract

Objectives

Stellate ganglion block [SGB] is a selective sympathetic blockade affecting the head, neck, and upper extremities. It is an important method that has been used most frequently in pain clinics due to its wide range of applications. However, there were some problems in SGB at C6 or C7. Various techniques were introduced to have a more successful SGB procedure. One of them is the oblique approach. This study was performed to evaluate the effectiveness of the oblique approach SGB at C7.

Methods

Sixty-eight patients with sudden hearing loss were studied. In Group 1, patients underwent the C7 oblique SGB with one percent mepivacaine 3 ml under fluoroscopic guidance. In Group 2, patients underwent the C7 classical anterior approach SGB with one percent mepivacaine 5 ml under fluoroscopic guidance. We compared the occurrences of Horner's syndrome, side effects, and changes in hand skin temperature.

Results

The rate of Horner's syndrome was 80.0 percent in Group 1 and 81.8 percent in Group 2. Increased skin temperature [≥34°C] of fingers was 77.1 percent and 78.8 percent in each group, respectively.

Conclusions

The C7 oblique approach SGB showed the same SGB effects compared with the C7 anterior approach SGB, and did not cause hoarseness. We concluded that the C7 oblique approach SGB may be a beneficial method for patients.

Keywords:

• Fluoroscopy guide
• oblique approach
• stellate ganglion block
• sensorineural hearing loss