A Comparison Between Ultrasound-Guided Stellate Ganglion Block And Traditional Blind Technique

Objectives:It has been almost a decade since the first application of stellate ganglion block (SGB) technique in the clinical practice. As the application expands continuously, the number of patient population undergoing this procedure grows steadily each year, the treatment complications of SGB technique have caught clinicians’ attention increasingly. Ultrasound-Guided SGB not only can reduce the occurrence of SGB procedure’s clinical complications, but also has higher therapeutic efficacy comparing to the traditional blind puncture technique. The aim of this study is to compare the safety and efficacy of stellate ganglion block, performed by ultrasound guided technique and blind technique, and to observe the fact with the advantage of the direct visualization, lower strength of anesthesia using ultrasound guided technique whether may achieve the same therapeutic effect as the higher strength of anesthesia using blind technique, thus, ultrasound guided technique may further minimize the risk of SGB puncture technique and improve patient’s tolerance of the procedure.Methods:A total number of 96 patients were selected for stellate ganglion block (SGB) procedure. They were randomly divided into 4 groups. Group U1:24 patient, received 5ml of 0.8% lidocaine though SGB with ultrasound-guided technique; Group Ml:24 patients, received 5ml of 0.8% lidocaine through SGB with blind technique; Group U2:24 patients, received 5ml of 0.4% lidocaine through SGB with ultrasound-guided technique; Group M2:24 patients, received 5ml of 0.4% lidocaine through SGB with blind technique. After the procedure, the rate of first time puncture success, the rate of Horner syndrome, the duration of Homer syndrome, and the rate of adverse complications of each group were recorded, evaluated and analyzed.Results:1.The first puncture success rate was significantly higher among Group U1 & U2 with ultrasound-guided technique comparing to Group M1 & M2 with traditional blind puncture technique,P<0.05.2. For the occurrence rate of Horner syndrome, comparing the same strength of the same dose of Lidocaine with different puncture techniques (Group U1 vs. M1, Group U2 vs. M2), it was higher with ultrasound-guided technique, P<0.05; among groups of the same puncture method with different strengths of the same dose of Lidocaine (Group U1 vs. U2, Group M1 vs. M2), there was no significant difference between Group U1 & U2 and Group M1 & M2.3.The duration of Horner syndrome among these 4 groups. There was no Significant diffetence between gtoup U1 and M1,P>0.05. there was Significant diffetence between gtoup U2 and M2,P<0.05. There was no Significant diffetence between gtoup U1 and U2,P>0.05. there was Significant diffetence between gtoup M1 and M2,P<0.05.4.For the occurrence of adverse complications, comparing the same strength of the same dose of Lidocaine with different puncture techniques (Group U1 vs. M1, Group U2 vs. M2), the rate was lower with ultrasound-guided technique; among groups with the same puncture method but different strengths of the same dose of Lidocaine (Group U1 vs. U2, Group Ml vs. M2), there was no significant difference between Group U1 & U2, but M1 had much higher rate of adverse complications occurrence comparing to M2.Conclusion(s):1, Stellate ganglion block (SGB) with ultrasound-guided technique is much safer and effective comparing to SGB with traditional blind puncture technique.2, With the Ultrasound-Guided SGB technique, the same therapeutic effect of medicine can be achieved even with lower strength of anesthesia.