Modified stellate ganglion block

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stellate ganglion block by modified approach

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Modified stellate ganglion block

  1. 1. Disclaimer A written informed consent has been taken from all the patients in this presentation regarding photography and display of photographs for scientific presentation.
  2. 2. Modified Stellate Ganglion Block Dr Ashok Jadon , MD DNB MNAMS Asculap Fellowship IPM Sr. Consultant & HOD Anaesthesia Tata Motors Hospital, Jamshedpur
  3. 3. Indications <ul><li>Pain Syndromes Complex Regional Pain Syndromes </li></ul><ul><li>Type I and II Refractory Angina Phantom Limb Pain </li></ul><ul><li>Vascular Insufficiency </li></ul><ul><li>Raynaud's Syndrome Scleroderma Frostbite Obliterative vascular disease vasospasm: trauma /emboli vascular reconstruction, </li></ul><ul><li>limb reimplatation </li></ul><ul><li>Edema </li></ul><ul><li>Local edema </li></ul><ul><li>surgery </li></ul>
  4. 4. Anatomical Facts
  5. 5. Conventional Approach
  6. 6. <ul><li>Horner’s Syndrome </li></ul><ul><ul><li>P tosis, </li></ul></ul><ul><ul><li>A nhydrosis, </li></ul></ul><ul><ul><li>M iosis, </li></ul></ul><ul><ul><li>E nophthalmos & </li></ul></ul><ul><ul><li>L oss of ciliospinal reflex </li></ul></ul><ul><li>Rise in limb temperature </li></ul><ul><li>Flushing of face </li></ul>Reduction in pain of Affected area ±
  7. 7. What is Modified? Chassignac's tubercle
  8. 9. Modified Stellate Ganglion Block. Abdi et al. Pain Physician. 2004;7:327-331
  9. 11. Uncinate Process C7 1 st Rib
  10. 12. Contrast
  11. 14. Case-1
  12. 15. Case-2
  13. 16. Case-3
  14. 17. Case-4
  15. 18. Case-5
  16. 19. Case-6
  17. 20. Summary <ul><li>9 cases CRPS </li></ul><ul><li>Modified Stellate Ganglion Block </li></ul><ul><li>No Serious Complication (s) </li></ul><ul><li>All showed clinical improvement </li></ul>
  18. 21. 2004 2010 2007 Modified Stellate Ganglion Block ?
  19. 22. Thank You Take Home Message
  20. 23. Complications <ul><li>NEEDLE IN THE WRONG PLACE Hematoma from vascular trauma Carotid trauma Internal jugular vein trauma Neural injury vagus brachial plexus roots Pulmonary injury Pneumothorax Hemothorax Thoracic duct injury Chylothorax Esophageal perforation </li></ul><ul><li>Intravascular injection Carotid artery Vertebral artery Internal jugular vein Neuraxial spread Epidural block Intrathecal Brachial plexus anesthesia Recurrent laryngeal nerve Phrenic nerve) </li></ul><ul><li>INFECTION </li></ul><ul><li>Esophageal perforation </li></ul><ul><li>Soft tissue (abscess) Neuraxial (meningitis) Bone (osteitis) </li></ul>

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