Block of the superior cervical ganglion, description of a novel ultrasound-guided technique in human cadavers.

Details

Serval ID
serval:BIB_5110669A6983
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Block of the superior cervical ganglion, description of a novel ultrasound-guided technique in human cadavers.
Journal
Pain Medicine
Author(s)
Siegenthaler A., Haug M., Eichenberger U., Suter M.R., Moriggl B.
ISSN
1526-4637 (Electronic)
ISSN-L
1526-2375
Publication state
Published
Issued date
2013
Volume
14
Number
5
Pages
646-649
Language
english
Notes
Publication types: Journal ArticlePublication Status: ppublish
Abstract
OBJECTIVE.: Injection of opioids to the superior cervical ganglion (SCG) has been reported to provide pain relief in patients suffering from different kinds of neuropathic facial pain conditions, such as trigeminal neuralgia, postherpetic neuralgia, and atypical facial pain. The classic approach to the SCG is a transoral technique using a so-called "stopper" to prevent accidental carotid artery puncture. The main disadvantage of this technique is that the needle tip is positioned distant from the actual target, possibly impeding successful block of the SCG. A further limitation is that injection of local anesthetics due to potential carotid artery puncture is contraindicated. We hypothesized that the SCG can be identified and blocked using ultrasound imaging, potentially increasing precision of this technique. INTERVENTIONS.: In this pilot study, 20 US-guided simulated blocks of the SCG were performed in 10 human cadavers in order to determine the accuracy of this novel block technique. After injection of 0.1 mL of dye, the cadavers were dissected to evaluate the needle position and coloring of the SCG. RESULTS.: Nineteen of the 20 needle tips were located in or next to the SCG. This corresponded to a simulated block success rate of 95% (95% confidence interval 85-100%). In 17 cases, the SCG was completely colored, and in two cases, the caudal half of the SCG was colored with dye. CONCLUSIONS.: The anatomical dissections confirmed that our ultrasound-guided approach to the SCG is accurate. Ultrasound could become an attractive alternative to the "blind" transoral technique of SCG blocks.
Pubmed
Web of science
Open Access
Yes
Create date
27/06/2013 18:02
Last modification date
20/08/2019 14:06
Usage data