| Autor: |
Mohamed Adly Elramely, Ahmed Abdelaal Ahmed Mahmoud M Alkhatip, Mohamed Khaled Hamza, Mohamed Abdelhaq, Mohamed Elayashy, Ehab Farag, Ahmed Shaker Ragab Ahmed |
| Rok vydání: |
2023 |
| Předmět: |
|
| Zdroj: |
British journal of pain. 16(6) |
| ISSN: |
2049-4637 |
| Popis: |
Background Despite being a well-described intervention, the optimal anatomical approach to perform a stellate ganglion block (SGB) has been disputed. We compared the subfascial and extrafascial ultrasound-guided (USG) SGB. Methods A randomised clinical trial was conducted, consisting of 50 patients in two groups. Group I received SGB via the subfascial approach while Group II received an SGB via the extrafascial approach. The primary endpoint was successful sympathetic blockade (as indicated by a measured temperature rise of ≥2°C). Secondary endpoints included analgesic efficiency (extent of early onset of pain relief as indicated by >50% improvement in Visual Analogue Scale (VAS) score at 300’s post-procedure); occurrence of Horner’s syndrome; extent of local anaesthetic distribution; and adverse events. Results The mean increase in sympathetic blockade was significantly higher in the subfascial group (2.6 ± 0.6°C; p = .003). Analgesic efficacy was also significantly higher in the subfascial group ( p < .001). The difference in the average dermatomal spread of local anaesthetic down to T2 and up to C4 between the groups was also statistically significant ( p = .021 and p = .019, respectively). Conclusions The degree of temperature rise, pain relief and occurrence of Horner's syndrome were higher in the subfascial than the extrafascial group. The subfascial approach to SGB, with a limited volume of local anaesthetic agent, is a more reliable technique when compared to the extrafascial approach. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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