Nerve block: stellate ganglion: Difference between revisions
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==Overview== | ==Overview== | ||
*Can be considered in cases of refractory ventricular fibrillation after other interventions have failed | *Can be considered in cases of refractory ventricular fibrillation after other interventions have failed<ref>Margus, C, Correa, A, Cheung, W, et al. Stellate ganglion nerve block by point-of-care ultrasonography for treatment of refractory infarction-induced ventricular fibrillation. Ann Emerg Med. 2020;75(2):257–260.</ref> | ||
*Theoretical benefit of blocking sympathetic drive leading to refractory dysrhythmia | *Theoretical benefit of blocking sympathetic drive leading to refractory dysrhythmia | ||
==Indications== | ==Indications== | ||
*Refractory ventricular fibrillation | *[[Pulseless arrest|Refractory ventricular fibrillation]] | ||
==Contraindications== | ==Contraindications== | ||
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[[File:stellate ganglion block.png|thumb|The red star above denotes the intended target for lidocaine injection<ref>Margus, C, Correa, A, Cheung, W, et al. Stellate ganglion nerve block by point-of-care ultrasonography for treatment of refractory infarction-induced ventricular fibrillation. Ann Emerg Med. 2020;75(2):257–260.</ref>]] | [[File:stellate ganglion block.png|thumb|The red star above denotes the intended target for lidocaine injection<ref>Margus, C, Correa, A, Cheung, W, et al. Stellate ganglion nerve block by point-of-care ultrasonography for treatment of refractory infarction-induced ventricular fibrillation. Ann Emerg Med. 2020;75(2):257–260.</ref>]] | ||
#Place probe over left anterior neck | |||
#Identify thyroid gland, carotid artery, C6/C7, longus colli muscle, and prevertebral fascia | |||
#Advance needle to stellate ganglion which is deep to prevertebral fascia and superficial to longus colli muscle | |||
#Inject 1-2 ml of anesthetic and observe dissection of the muscle and fascia layers to confirm placement | |||
#With placement confirmed, inject the rest of the anesthetic for a total of 10ml of volume | |||
==Complications== | ==Complications== | ||
| Line 31: | Line 27: | ||
==See Also== | ==See Also== | ||
[[Pulseless arrest]] | *[[Nerve and regional blocks (main)]] | ||
*[[Pulseless arrest]] | |||
[[Double simultaneous external defibrillation]] | *[[Double simultaneous external defibrillation]] | ||
==External Links== | ==External Links== | ||
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==References== | ==References== | ||
<references/> | <references/> | ||
[[Category:Procedures]] | [[Category:Procedures]] | ||
Latest revision as of 00:39, 19 January 2021
Overview
- Can be considered in cases of refractory ventricular fibrillation after other interventions have failed[1]
- Theoretical benefit of blocking sympathetic drive leading to refractory dysrhythmia
Indications
Contraindications
- Overlying skin infection
Equipment Needed
- Ultrasound with high frequency linear transducer
- 2.5-5cm 22-gauge spinal needle
- 10ml of 1% lidocaine without epinephrine
Procedure
The red star above denotes the intended target for lidocaine injection[2]
- Place probe over left anterior neck
- Identify thyroid gland, carotid artery, C6/C7, longus colli muscle, and prevertebral fascia
- Advance needle to stellate ganglion which is deep to prevertebral fascia and superficial to longus colli muscle
- Inject 1-2 ml of anesthetic and observe dissection of the muscle and fascia layers to confirm placement
- With placement confirmed, inject the rest of the anesthetic for a total of 10ml of volume
Complications
- Accidental injection of anesthetic into vascular structure
See Also
External Links
References
- ↑ Margus, C, Correa, A, Cheung, W, et al. Stellate ganglion nerve block by point-of-care ultrasonography for treatment of refractory infarction-induced ventricular fibrillation. Ann Emerg Med. 2020;75(2):257–260.
- ↑ Margus, C, Correa, A, Cheung, W, et al. Stellate ganglion nerve block by point-of-care ultrasonography for treatment of refractory infarction-induced ventricular fibrillation. Ann Emerg Med. 2020;75(2):257–260.