Ultrasound image guided lateral cervical approach to stellate ganglion block for cervical headache

Objective: To explore the feasibility and safety of real-time ultrasound-guided transcervical lateral stellate ganglion block.

Methods: From September 2017 to December 2018, 80 cases of cervical headache were diagnosed by high-frequency ultrasound on the lateral cervical region, and evaluated at the level of the transverse process of cervical vertebrae 6 and 7. Risk factors for the ganglia. Choose a safe path and guide puncture and drug injection in real time.

Results: The lateral approach of horizontal C6 and C7 transverse processes in 80 cases was explored. There are risk factors on the 32-sided puncture path, in which the inferior thyroid artery accounts for 34.4 % (11/32), the jugular vein accounts for 31.2 % (10/32), and the vertebral arteriovenous accounts for 12.5 % (4/32) The other arteries accounted for 21.9 % (7/32). The puncture was completed in 79 cases, and one patient gave up the puncture because of risk factors in the horizontal puncture path of C6 and C7. Horner syndrome occurred in 79 cases within 10 min after puncture. There were 4 cases (5.1 %) of minor side effects, including hoarseness in 2 cases, numbness in upper limbs and dizziness in 1 case, all of which resolved on their own. The VAS score of 79 cases before block (8.9 ± 0.9) points and 0.5h VAS score (5.7 ± 2.1) points after block were significantly lower than those before block (t = 13.154, P = 0.003); 1dVAS score (5.3 ± 2.5) after block was significantly lower than that before block (t = 12.626, P = 0.002).

Conclusion: High-frequency ultrasound guided stellate ganglion block in lateral cervical approach in real time has a high success rate and the method is safe.

Keywords: Nerve block; Stellate ganglia; Ultrasound.