CT-GUIDED INJECTION OF THE STELLATE GANGLION - DESCRIPTION OF TECHNIQUE AND EFFICACY OF SYMPATHETIC BLOCKADE

Stellate ganglion blockade, typically performed by using palpable osse ous landmarks, is an accepted method in the diagnosis and treatment of sympathetically maintained pain and other conditions. The authors pre sent the results of stellate ganglion injection performed with compute d tomographic (CT) guidance. Thirteen CT-guided procedures were perfor med in seven patients. Lidocaine, bupivacaine, and buprenorphine were used to achieve the blockade. Successful blocks were achieved in all 1 3 cases as evidenced by production of Horner syndrome and ipsilateral hand temperature elevations. The average ipsilateral and contralateral hand temperature changes following the procedure were 7.5-degrees-C a nd 0.5-degrees-C. The ipsilateral hand temperature changes and the dif ferences between the ipsilateral and contralateral hand temperature ch anges exceeded 1.5-degrees-C in every case. Five patients preferred th e CT-guided procedure over the conventional technique, and two patient s noted no substantial difference between the approaches. With the CT- guided technique, a highly effective sympathetic block is achieved wit h a substantially reduced volume of anesthetic compared with the conve ntional approach.