Ann Rehabil Med.  2012 Oct;36(5):633-639.

Efficacy of Ultrasonography Guided Stellate Ganglion Blockade in the Stroke Patients with Complex Regional Pain Syndrome

• Yoo SD
• Jung SS
• Kim HS
• Yun DH
• Kim DH
• Chon J
• Hong DW

Abstract

OBJECTIVE
To compare the efficacy of ultrasonography guided stellate ganglion block (US-SGB) with that of blind SGB in management of the stroke patients with complex regional pain syndrome (CRPS) type 1. METHOD: Forty-two patients with post-stroke CRPS were randomly assigned to either US-guided SGB (22 patients) or blind SGB group (20 patients). The mean age of US-guided SGB and blind SGB groups was 61.3+/-5.6 years and 59.1+/-4.5 years. We performed two blockades at 7-day intervals on the affected side of patients with CRPS. Pain intensity, using a visual analog score (VAS), score of CRPS clinical severity, and the amounts of affected hand swelling with a hand volumeter were assessed before, 2 weeks and 4 weeks after treatment.
RESULTS
In both groups, VAS and the amount of hand swelling were significantly decreased after 2 weeks and after 4 weeks. Between two groups, VAS difference of US-guided SGB group and that of blind SGB group were 2.61+/-1.09, 1.88+/-0.62 at 2 weeks and 3.67+/-1.03, 3.13+/-0.62 at 4 weeks, respectively. US-guided SGB group showed more significant improvement in mean change of VAS compared to the blind SGB group (p-value<0.05).
CONCLUSION
Both US-guided SGB and blind SGB techniques were effective in relieving pain in subacute stroke patients with CRPS. US-guided SGB was better in pain relief but has no advantages in reduction of hand swelling in this study.

Keyword

Complex regional pain syndrome; Stroke; Ultrasonography guided Stellate ganglion blockade

MeSH Terms

Hand
Humans
Stellate Ganglion
Stroke

Figure

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  Fig. 1 Ultrasonography imaging of the left stellate ganglion & prevertebral fascia (asterisks). Needle was advanced with real-time ultrasonography so that the needle tip will lie anterior to the longus coli. Th: Thyroid, LCo: Longus coli muscle, LCp: Longus capitus muscle, CA: Carotid artery, SCM: Sternocleidomastoid muscle, TP: Transverse process.

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