Nerve block: stellate ganglion
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.