Stellate ganglion blockade-techniques and modalities. 2016

A Ghai, and T Kaushik, and R Wadhera, and S Wadhera

Stellate ganglion block (SGB) is utilized in the diagnosis and management of various vascular disorders and sympathetically mediated pain in upper extremity, head and neck. The stellate ganglion lies medial to the scalene muscles, lateral to longus coli muscle, esophagus, trachea and recurrent laryngeal nerve, anterior to C7 transverse process and prevertebral fascia, superior to the subclavian artery and posterior to vertebral vessels. Consequently, inadvertent placement of the needle tip into these soft tissues and vessels occur with blind technique. Henceforth, various interventional modalities are being used for SGB, these have been reviewed in this paper. Various techniques of SGB have been described, and vary from the use of standard blind technique to the use of fluoroscopy, computerized tomography, magnetic resonance imaging, and radio nucleotide tracers. However, these techniques may not be practical in a clinical setting, insofar as they are time consuming, costly, and may involve radiation exposure. The use of fluoroscopy does not visualize the blood vessels close to the stellate ganglion. Ultrasounds are the alternative. They help in visualization of soft tissues to prevent complications and help in deposition of drug subfascially, under direct visual control.

UI MeSH Term Description Entries
D008279 Magnetic Resonance Imaging Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. Chemical Shift Imaging,MR Tomography,MRI Scans,MRI, Functional,Magnetic Resonance Image,Magnetic Resonance Imaging, Functional,Magnetization Transfer Contrast Imaging,NMR Imaging,NMR Tomography,Tomography, NMR,Tomography, Proton Spin,fMRI,Functional Magnetic Resonance Imaging,Imaging, Chemical Shift,Proton Spin Tomography,Spin Echo Imaging,Steady-State Free Precession MRI,Tomography, MR,Zeugmatography,Chemical Shift Imagings,Echo Imaging, Spin,Echo Imagings, Spin,Functional MRI,Functional MRIs,Image, Magnetic Resonance,Imaging, Magnetic Resonance,Imaging, NMR,Imaging, Spin Echo,Imagings, Chemical Shift,Imagings, Spin Echo,MRI Scan,MRIs, Functional,Magnetic Resonance Images,Resonance Image, Magnetic,Scan, MRI,Scans, MRI,Shift Imaging, Chemical,Shift Imagings, Chemical,Spin Echo Imagings,Steady State Free Precession MRI
D010146 Pain An unpleasant sensation induced by noxious stimuli which are detected by NERVE ENDINGS of NOCICEPTIVE NEURONS. Suffering, Physical,Ache,Pain, Burning,Pain, Crushing,Pain, Migratory,Pain, Radiating,Pain, Splitting,Aches,Burning Pain,Burning Pains,Crushing Pain,Crushing Pains,Migratory Pain,Migratory Pains,Pains, Burning,Pains, Crushing,Pains, Migratory,Pains, Radiating,Pains, Splitting,Physical Suffering,Physical Sufferings,Radiating Pain,Radiating Pains,Splitting Pain,Splitting Pains,Sufferings, Physical
D005471 Fluoroscopy Production of an image when x-rays strike a fluorescent screen. Fluoroscopies
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000779 Anesthetics, Local Drugs that block nerve conduction when applied locally to nerve tissue in appropriate concentrations. They act on any part of the nervous system and on every type of nerve fiber. In contact with a nerve trunk, these anesthetics can cause both sensory and motor paralysis in the innervated area. Their action is completely reversible. (From Gilman AG, et. al., Goodman and Gilman's The Pharmacological Basis of Therapeutics, 8th ed) Nearly all local anesthetics act by reducing the tendency of voltage-dependent sodium channels to activate. Anesthetics, Conduction-Blocking,Conduction-Blocking Anesthetics,Local Anesthetic,Anesthetics, Topical,Anesthetic, Local,Anesthetics, Conduction Blocking,Conduction Blocking Anesthetics,Local Anesthetics,Topical Anesthetics
D001340 Autonomic Nerve Block Interruption of sympathetic pathways, by local injection of an anesthetic agent, at any of four levels: peripheral nerve block, sympathetic ganglion block, extradural block, and subarachnoid block. Sympathetic Nerve Block,Autonomic Nerve Blocks,Block, Autonomic Nerve,Block, Sympathetic Nerve,Blocks, Autonomic Nerve,Blocks, Sympathetic Nerve,Nerve Block, Autonomic,Nerve Block, Sympathetic,Nerve Blocks, Autonomic,Nerve Blocks, Sympathetic,Sympathetic Nerve Blocks
D013233 Stellate Ganglion A paravertebral sympathetic ganglion formed by the fusion of the inferior cervical and first thoracic ganglia. Cervicothoracic Ganglion,Cervicothoracic Ganglia,Stellate Ganglia,Ganglia, Cervicothoracic,Ganglia, Stellate,Ganglias, Stellate,Ganglion, Cervicothoracic,Ganglion, Stellate,Stellate Ganglias
D014057 Tomography, X-Ray Computed Tomography using x-ray transmission and a computer algorithm to reconstruct the image. CAT Scan, X-Ray,CT Scan, X-Ray,Cine-CT,Computerized Tomography, X-Ray,Electron Beam Computed Tomography,Tomodensitometry,Tomography, Transmission Computed,X-Ray Tomography, Computed,CAT Scan, X Ray,CT X Ray,Computed Tomography, X-Ray,Computed X Ray Tomography,Computerized Tomography, X Ray,Electron Beam Tomography,Tomography, X Ray Computed,Tomography, X-Ray Computer Assisted,Tomography, X-Ray Computerized,Tomography, X-Ray Computerized Axial,Tomography, Xray Computed,X Ray Computerized Tomography,X Ray Tomography, Computed,X-Ray Computer Assisted Tomography,X-Ray Computerized Axial Tomography,Beam Tomography, Electron,CAT Scans, X-Ray,CT Scan, X Ray,CT Scans, X-Ray,CT X Rays,Cine CT,Computed Tomography, Transmission,Computed Tomography, X Ray,Computed Tomography, Xray,Computed X-Ray Tomography,Scan, X-Ray CAT,Scan, X-Ray CT,Scans, X-Ray CAT,Scans, X-Ray CT,Tomographies, Computed X-Ray,Tomography, Computed X-Ray,Tomography, Electron Beam,Tomography, X Ray Computer Assisted,Tomography, X Ray Computerized,Tomography, X Ray Computerized Axial,Transmission Computed Tomography,X Ray Computer Assisted Tomography,X Ray Computerized Axial Tomography,X Ray, CT,X Rays, CT,X-Ray CAT Scan,X-Ray CAT Scans,X-Ray CT Scan,X-Ray CT Scans,X-Ray Computed Tomography,X-Ray Computerized Tomography,Xray Computed Tomography
D014652 Vascular Diseases Pathological processes involving any of the BLOOD VESSELS in the cardiac or peripheral circulation. They include diseases of ARTERIES; VEINS; and rest of the vasculature system in the body. Disease, Vascular,Diseases, Vascular,Vascular Disease
D018084 Ultrasonography, Interventional The use of ultrasound to guide minimally invasive surgical procedures such as needle ASPIRATION BIOPSY; DRAINAGE; etc. Its widest application is intravascular ultrasound imaging but it is useful also in urology and intra-abdominal conditions. Ultrasonography, Intravascular,Ultrasound, Interventional,Interventional Ultrasonography,Intravascular Ultrasonography,Interventional Ultrasound

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