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The purpose of this study was to compare the temperature changes of the upper extremities when using local anesthetic of various volume (4ml, 6ml, 8ml) in the ultrasound guided stellate ganglion block.
One pain physician performs all US-guided stellate ganglion block(SGB)s, who is not involved in evaluating study variables. Electrocardiography, noninvasive blood pressure, heart rate, and peripheral oxygen saturation were monitored for all patients before, while, and after conducting procedure.
For US-guided SGB, patients are supine positioned, and skin preparation on injection site is done with chlorohexidine. Procedure is conducted under ultrasound guidance at C6 level. 4ml, 6ml, and 8ml of 1% lidocaine is injected for the each group, respectively. Syringes are prepared by one nurse who do not involved in other steps of this study.
Temperature measurement is conducted 4 times (before US-guided SGB and after 10, 20, and 30m from SGB) at both hands, face, axillar by one person who's not involved in other measuring in the study.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| 4 ml of 1% lidocaine | Active Comparator | Procedure: 4 ml of 1% lidocaine is injected for stellate ganglion block using the Ultrasound(US)-guided lateral approach at the sixth cervical vertebral level. |
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| 6 ml of 1% lidocaine | Active Comparator | Procedure: 6 ml of 1% lidocaine is injected for stellate ganglion block using the US-guided lateral approach at the sixth cervical vertebral level. |
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| 8 ml of 1% lidocaine | Active Comparator | Procedure: 8 ml of 1% lidocaine is injected for stellate ganglion block using the US-guided lateral approach at the sixth cervical vertebral level. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Stellate ganglion block | Procedure | Well trained pain physician performs all the ultrasound(US)-guided stellate ganglion block(SGB)s, who is not involved in evaluating study variables. Electrocardiography, noninvasive blood pressure, heart rate, and peripheral oxygen saturation were monitored for all patients before, while, and after conducting procedure. For US-guided SGB, patients are supine positioned, and skin preparation on injection site is done with chlorohexidine. Procedure is conducted under ultrasound guidance at C6 level. 4 ml, 6 ml, and 8 ml of 1% lidocaine is injected for the each group, respectively. |
| Measure | Description | Time Frame |
|---|---|---|
| Temperature change(°C) in ipsilateral arm | Temperature is measured with a laser thermometer on the palmar aspect of 3 cm below from the middle finger. | thirty minute after US-guided SGB |
| Measure | Description | Time Frame |
|---|---|---|
| Temperature changes(°C) in ipsilateral arm | Temperature is measured with a laser thermometer on the palmar aspect of 3 cm below from the middle finger. | 10 and 20 min after US-guided SGB |
| Temperature changes in ipsilateral face |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Jee Youn Moon, MD, PhD | Seoul National University Hospital | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Seoul National University Hospital | Seoul | South Korea |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 7577781 | Background | Kapral S, Krafft P, Gosch M, Fleischmann D, Weinstabl C. Ultrasound imaging for stellate ganglion block: direct visualization of puncture site and local anesthetic spread. A pilot study. Reg Anesth. 1995 Jul-Aug;20(4):323-8. | |
| 11289093 | Background | Schurmann M, Gradl G, Wizgal I, Tutic M, Moser C, Azad S, Beyer A. Clinical and physiologic evaluation of stellate ganglion blockade for complex regional pain syndrome type I. Clin J Pain. 2001 Mar;17(1):94-100. doi: 10.1097/00002508-200103000-00012. |
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| ID | Term |
|---|---|
| D009437 | Neuralgia |
| ID | Term |
|---|---|
| D010523 | Peripheral Nervous System Diseases |
| D009468 | Neuromuscular Diseases |
| D009422 | Nervous System Diseases |
| D010146 | Pain |
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Temperature is measured with a laser thermometer on a junction between the extended lines from pupil and nostril.
| 10, 20, and 30 min after US-guided SGB |
| Temperature changes in contralateral face | Temperature is measured with a laser thermometer on a junction between the extended lines from pupil and nostril. | 10, 20, and 30 min after US-guided SGB |
| Temperature changes in ipsilateral medial elbow | Temperature is measured with a laser thermometer on the forearm area (3 cm above the medial epicondyle). | 10, 20, and 30 min after US-guided SGB |
| Temperature changes in contralateral medial elbow | Temperature is measured with a laser thermometer on the forearm area (3 cm above the medial epicondyle). | 10, 20, and 30 min after US-guided SGB |
| Severity of pain using an 11-pointed numerical rating scale(NRS) pain score | The pain NRS is a single 11-point numeric scale. An 11-point numeric scale (NRS 11) with 0 representing one pain extreme (e.g., "no pain") and 10 representing the other pain extreme (e.g., "pain as bad as you can imagine" and "worst pain imaginable"). The NRS will be administered verbally or graphically for self-completion. The respondent is asked to indicate the numeric value on the segmented scale that best describes their pain intensity. The number that the respondent indicates on the scale to rate their pain intensity is recorded. Scores range from 0-10. Higher scores indicate greater pain intensity. | Time before block and time of block to 30 minutes after the block |
| Proportion of patients reaching >1.5°C rise of temperature in the ipsilateral arm compared to the contralateral arm | Temperature is measured with a laser thermometer on the palmar aspect of 3 cm below from the middle finger. | 30 minutes after the block |
| Proportion of patients reaching >1.5°C rise of temperature in the ipsilateral face compared to the contralateral face | Temperature is measured with a laser thermometer on a junction between the extended lines from pupil and nostril. | 30 minutes after the block |
| Proportion of patients with ptosis | Check the distance between upper lid margin and light reflex(MRD). | 30 minutes after the block |
| 21490819 | Result | Jung G, Kim BS, Shin KB, Park KB, Kim SY, Song SO. The optimal volume of 0.2% ropivacaine required for an ultrasound-guided stellate ganglion block. Korean J Anesthesiol. 2011 Mar;60(3):179-84. doi: 10.4097/kjae.2011.60.3.179. Epub 2011 Mar 30. |
| 9613538 | Result | Stevens RA, Stotz A, Kao TC, Powar M, Burgess S, Kleinman B. The relative increase in skin temperature after stellate ganglion block is predictive of a complete sympathectomy of the hand. Reg Anesth Pain Med. 1998 May-Jun;23(3):266-70. doi: 10.1016/s1098-7339(98)90053-0. |
| D009461 |
| Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |