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The first purpose of this study is to compare the effectiveness of the stellate ganglion block realized with two different approaches (blind and ultrasound-guided) in patients with a diagnosis of complex regional pain syndrome.
The second purpose of this study is to determine the safest approach and to compare the safety profiles of the two approaches.
To evaluate whether the ultrasound guided approach is more effective than the blind technique in producing a greater than 1.5 degree Celsius rise in ipsilateral arm temperature after a stellate ganglion block.
Blocks will both be performed with 10 mL of xylocaine/bupivacaine. Secondary outcomes will be the impact of the approach (blind vs ultrasound) on pain reduction, horner syndrome, side effects (hoarseness, dysphagia, pharyngeal discomfort) and complications (blood aspiration, intravascular injection).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Blind technique | Active Comparator | Stellate ganglion block using the anterior paratracheal approach using surface landmarks. |
|
| Ultrasound-guided technique | Active Comparator | Stellate ganglion block using the ultrasound-guided lateral approach at the sixth cervical vertebral level. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Blind technique | Procedure | A mixture of 3 mL of 2% lidocaine and 7 mL of 0.5% bupivacaine is used for both approaches (blind and ultrasound-guided). |
|
| Measure | Description | Time Frame |
|---|---|---|
| proportion of patients reaching >1.5 °C rise in ipsilateral arm temperature | thirty minutes after block |
| Measure | Description | Time Frame |
|---|---|---|
| Complications | Seizure, loss of consciousness with apnea, hematoma, recurrent laryngeal nerve injury, phrenic nerve paralysis, pneumothorax, weakness of the ipsilateral upper limb, foreign body sensation | Time of the block to one week after the block |
| Measure | Description | Time Frame |
|---|---|---|
| Severity of pain | The severity of the pain will be evaluated before the block and each day after the block for one week using a numeric rating scale (0-10). | Immediately and each day after the block until one week after the block |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Veronique Brulotte, MD, MSC, FRCPC | Maisonneuve-Rosemont Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Maisonneuve-Rosemont Hospital | Montreal | Quebec | H1T2M4 | Canada |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 22956268 | Background | Bhatia A, Flamer D, Peng PW. Evaluation of sonoanatomy relevant to performing stellate ganglion blocks using anterior and lateral simulated approaches: an observational study. Can J Anaesth. 2012 Nov;59(11):1040-7. doi: 10.1007/s12630-012-9779-4. Epub 2012 Sep 6. |
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| ID | Term |
|---|---|
| D020918 | Complex Regional Pain Syndromes |
| ID | Term |
|---|---|
| D001342 | Autonomic Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D010523 | Peripheral Nervous System Diseases |
| D009468 | Neuromuscular Diseases |
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| Ultrasound-guided technique | Procedure | A mixture of 3 mL of 2% lidocaine and 7 mL of 0.5% bupivacaine is used for both approach (blind and ultrasound-guided). |
|