Revalidation of a modified and safe approach of stellate ganglion block

Abstract

Stellate ganglion block (SGB) is very effective in management of chronic regional pain syndrome (CRPS-1). However, serious complication may occur due to accidental intravascular (intra-arterial) injection of local anaesthetic agents. Abdi and others, has suggested a modified technique in which fluoroscopy-guided block is given at the junction of uncinate process and body of vertebra at C7 level. In this approach vascular structures remain away from the trajectory of needle and thus avoid accidental vascular injection. We have used this technique of SGB in nine patients who were treated for CRPS-I. The blocks were effective in all the patients all the time without any vascular or other serious complication.

Keywords: CRPS-I; modified technique; stellate ganglion block.

Figure 1a

Neck extended and rotated to opposite side

Figure 1b

C-arm is rotated in opposite direction of head turn

Figure 1c

X-ray image shows uncinate process of C7 and intervertebral foramina

Figure 2a

spinal needle at uncinate process of C7 left

Figure 2b

Contrast spreading up and down

Figure 2c

Contrast spreading up to head of 1^st rib