Stellate Block

26 Stellate Block



Perspective


The primary use of stellate block is in the diagnosis and treatment of complex regional pain syndromes of the upper extremity. It may also be used in clinical situations when increased perfusion to the upper extremity is desired, although this can also be accomplished with the brachial plexus blocks.




Patient Selection


Patients for this block are primarily those with complex regional pain syndromes of the upper extremity or those with impaired perfusion to the upper extremity after trauma.



Pharmacologic Choice


Even during diagnostic use of stellate ganglion block, it is often desirable to produce a long-lasting block. Therefore, a solution of 0.25% bupivacaine, or 0.2% ropivacaine with 1:200,000 epinephrine is often my first choice.



Placement




Anatomy


The cervical sympathetic trunk is a cephalad continuation of the thoracic sympathetic trunk. It is composed of three ganglia: the superior cervical ganglion, generally opposite the first cervical vertebra; the middle cervical ganglion, usually opposite the sixth cervical vertebra; and the stellate (cervicothoracic) ganglion, generally opposite the seventh cervical and first thoracic vertebrae near the head of the first rib. The stellate ganglion is a fusion of the inferior cervical ganglion and the first thoracic ganglion—hence the name cervicothoracic ganglion (Fig. 26-1

Only gold members can continue reading. Log In or Register to continue

Related posts:

Distal Upper Extremity Block Translaryngeal Block Supraclavicular Block Sciatic Block Superior Hypogastric Plexus Block Celiac Plexus Block

Stay updated, free articles. Join our Telegram channel
Tags:
May 31, 2016 | Posted by in ANESTHESIA | Comments Off on Stellate Block

Full access? Get Clinical Tree
Get Clinical Tree app for offline access