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PubMed1981

The distribution of the sympathetic preganglionic neurons projecting onto the stellate ganglion of the guinea pig. A horseradish peroxidase study.

After injection of horseradish peroxidase (HRP) into the stellate ganglion (SG) of the guinea pig, labelled cells were found in the C8-T11 spinal cord segments. The HRP-positive neurons were located in the nucleus intermedio-lateralis pars principalis and funicularis (ILp and ILf) and in the nucleus intercalatus proprius and pars paraependymalis (ICp and ICpe). The ICp and ICpe neurons represented approximately one-fourth of the total number of labelled cells. The ILp and ILf neurons were mainly located in the T2 and T3 segments whereas the ICp and ICpe neurons occurred mainly in the T4 to T6 segments where the ICpe cell group formed a continuous cell column dorsal to the central canal. The possible correlation between the segmental distribution and peripheral sympathetic effects was discussed.

Adrenergic Fibers↗
PubMed2006

Circadian variations of stellate ganglion nerve activity in ambulatory dogs.

BACKGROUND: The presence of circadian variations in sympathetic outflow from the stellate ganglia is unclear. OBJECTIVES: The purpose of this study was to continuously record stellate ganglion nerve activity (SGNA) in ambulatory dogs. METHODS: We performed continuous 24-hour left (N = 3) or bilateral (N = 3) SGNA recordings in normal ambulatory dogs using implanted Data Sciences International transmitters. We also performed simultaneous ECG recording (n = 5) or simultaneous ECG and blood pressure recordings (n = 1). RESULTS: The total duration of continuous ambulatory recording averaged 41.5 +/- 16.6 days. Five dogs had persistent stable recording, and one dog developed hardware malfunction in week 3. SGNA was followed immediately (<1 second) by heart rate and blood pressure elevation and a reduced standard deviation of consecutive activation cycle length (SDNN) from 236 +/- 93 ms to 121 +/- 51 ms (P = 0.007). Heart rate correlated significantly with SGNA. When there was a sudden increase of SGNA, the sudden increase occurred bilaterally in 90% of the episodes. Both heart rate and SGNA showed statistically significant (P <.01) circadian variation. Nadolol (20 mg/day for 5 days) reduced average heart rate from 99 +/- 8 bpm at baseline to 88 +/- 9 bpm (N = 6, P = .001) but did not significantly alter SGNA. Immunohistochemical staining of the stellate ganglia showed tyrosine hydroxylase-positive ganglion cells and nerves at the recording site. CONCLUSION: There is a circadian variation in sympathetic outflow from canine stellate ganglia. Circadian variation of SGNA is an important cause of circadian variations of cardiac sympathetic tone.

Adrenergic beta-Antagonists↗
PubMed1989

Stellate ganglion block with bupivacaine. Minimum effective concentration of bupivacaine and the effect of added potassium.

Sympathetic blockade after stellate ganglion block with bupivacaine was assessed by liquid crystal thermography. The minimum concentration of bupivacaine required for successful block was between 325 and 406 mumol/litre. Further study of bupivacaine in a solution that contained potassium 5 mmol/litre showed that this reduced the minimum concentration of bupivacaine required for successful block to between 81 and 162 mumol/litre. We conclude that potassium has a major effect on the minimum concentration of bupivacaine required for sympathetic blockade.

Bupivacaine↗
PubMed1994

[The effect of stellate ganglion block on the local and global cardiac uptake of 123I-metaiodobenzylguanidine].

To investigate the effect of stellate ganglion block (SGB) on the cardiac uptake of 123I-metaiodobenzylguanidine (MIBG), four patients without heart disease underwent SGB. Studies were done twice: once with SGB and once without SGB. Anterior planar images and myocardial SPECT images were taken at 10 minutes and 60 minutes after MIBG injection both with and without SGB. Cardiac uptake of MIBG on planar images estimated by heart/liver ratio was significantly higher with SGB at both imaging times (p < 0.01, p < 0.05) than without SGB. SGB had no effect on the local uptake of MIBG on SPECT images. In conclusion, SGB did not change the local cardiac uptake of MIBG, but it appeared to increase the global myocardial uptake of MIBG.

3-Iodobenzylguanidine↗
PubMed2001

The acute effects of stellate ganglion block on circulation in human ocular fundus.

PURPOSE: To study the acute effects of local-anesthetic stellate ganglion block (SGB) on tissue circulation in the human fundus. METHODS: Eleven patients with Bell's palsy (age 56+/-6 y, mean+/-SD) who underwent SGB for its treatment participated in the study. Using the laser speckle method, normalized blur (NB) value, a quantitative index of tissue blood velocity, was measured every 0.125 s over an area located halfway between the macula and the optic nerve head (ONH) with no discrete visible vessels and averaged over 3 pulses when fixation was satisfactory (NB(ch-ret)). NB(ch-ret) and intraocular pressure (IOP) in both eyes, blood pressure (BP), and pulse rate (PR) were measured before, and 10, 20, 30, and 60 min after SGB. SGB was induced by injecting 1% mepivacaine hydrochloride (5 ml) into the vicinity of the seventh cervical vertebra on the paralyzed side. RESULTS: The IOP in the blocked side significantly decreased between 20 and 60 min following SGB, compared to the baseline, while IOP in the unblocked side remained unchanged. The NB(ch-ret) was significantly increased after 10 min by about 8% in the blocked side, but its effect almost disappeared at 60 min. There was no significant change in NB(ch-ret) in the unblocked side, BP or PR throughout the experimental period. CONCLUSION: SGB increased tissue circulation in the fundus in the blocked side, but its effect was thought to be small and transient.

Anesthetics, Local↗
PubMed1990

Plasma concentrations of bupivacaine after stellate ganglion block using two volumes of 0.25% bupivacaine plain solution.

Plasma concentrations of bupivacaine were measured in patients after stellate ganglion block using either 10 or 20 ml of 0.25% plain solution. The mean peak concentrations were greater in the larger volume group, but this was not statistically significant. From 30 min after injection, there was a significantly greater plasma concentration in the larger volume group. The concentrations approached the limit of detection in the smaller volume group at 2 h after block.

Anesthesia, Local↗
PubMed1976

Ultrastructure of Lewy bodies in the stellate ganglion.

The Lewy body, a characteristic nerve cell inclusion in idiopathic parkinsonism, was examined by electron microscopy in the stellate ganglion, obtained from 9 patients at autopsy. Three main forms of Lewy bodies or Lewy body-related structures were demonstrated: A.Rare filamentous Lewy bodies, similar to Lewy bodies in the central nervous system. B. Granular Lewy bodies in nerve cell processes. C. Abnormal nerve cell processes, filled with heterogenous material. Large dense core vesicles were prominent in the last 2 forms. None of these abnormalities were found in 2 control groups consisting of 9 parkinsonism cases without central nervous system Lewy bodies, and 17 cases without parkinsonism. The filamentous Lewy body (type A) was found in the perikaryon and was surrounded by neuromelanin, whereas the other forms (type B and C) were seen in nerve cell processes. Mitochondrial inclusions, present mainly, but not exclusively, in neuromelanin-containing cells, were not related to Lewy body formation or to parkinsonism.

Aged↗
PubMed1981

Stellate ganglion influence on static compliance and surface layer lipids in cat lungs.

In order to determine the effects of stellate ganglion stimulation (SGS) on static lung compliance, pressure-volume relationships were measured on lungs in situ in cats anesthetized with ketamine. The lungs were inflated with 100% oxygen to 100, 93.75, 87.5, 81.25, 75, 50, and 25% TLC as determined at 20 cm H2O transpulmonary pressure. After a maximal filling, lungs were inflated twice to each volume, alternating unstimulated and SGS conditions. Static lung compliance was decreased by SGS at 93.75 (5.7 +/- 0.4 (SE) vs. 5.4 +/- 0.4 ml/cm H2O; P less than 0.05) and 87.5% TLC (6)6 +/- 0.6 vs 6.0 +/- 0.5 ml/cm H2O; P less than 0.05). In order to assess possible effects of SGS on surfactant that might be related to the loss of compliance, lung lipids and proteins obtained during SGS were quantitated. Total phospholipid (TPL) increased from 3.22 +/- 0.33 to 4.16 +/- 0.23 mg/g lung after 1 min 7V SGS (P less than 0.05) and to 4.58 +/- 0.61 mg/g lung after 4 min 20V (P less than 0.05). The ratio of cholesterol (chol) to disaturated phosphatidylcholine (DSPC) decreased after 4 and 6 min, and may have resulted in increased surface tension forces at high lung volumes. The data from this study lend support to previous findings which showed that the compliance decrease during SGS may be related to increased surface tension forces.

Animals↗
PubMed1994

[Influence of stellate ganglion block on bilateral cervicobrachial arterial and venous blood flow].

This study was designed to investigate the influence of stellate ganglion block (SGB) on cervicobrachial arterial and venous blood flow in 12 mongrel dogs. Following general anesthesia, the animals were mechanically ventilated to maintain a constant PaCO2 (35-40 mmHg). After thoracotomy, each dog was given SGB with 0.5% mepivacaine 1.0 ml. In six dogs we measured bilateral common carotid arterial blood flows (CCAF) and external jugular venous blood flows (EJVF), and in other six dogs we measured bilateral brachial arterial blood flows (BAF) and brachial venous blood flows (BVF) before and after SGB by using an ultrasonic transit time flowmeter. CCAF and EJVF in the blocked side and contra-lateral EJVF increased significantly but contra-lateral CCAF decreased significantly after SGB. BAF and BVF in the blocked side increased significantly and contra-lateral BAF and BVF decreased significantly after SGB. The results suggest that increased arterial blood flow in the blocked side after SGB is due to vasodilatation by sympathetic block and that contra-lateral arterial blood flow decreases by the ensuing lending-borrowing phenomenon. Increased venous blood flow in the blocked side after SGB is probably due to vasodilatation by sympathetic block and passive increase of blood flow from increased arterial blood flow. Contra-lateral increased EJVF may also be due to passive increase from arterial blood flow of the blocked side.

Animals↗
PubMed1959

Ultrasound; its effect on the cardiovascular system when applied over the carotid sinus and stellate ganglion.

In a study of 29 patients to observe untoward reactions to applications of ultrasound over the carotid sinus and stellate ganglion areas, it was noted that cough was evoked in five patients, premature ventricular systoles in three and a burning sensation of the skin at the point of treatment in five. No considerable effect on heart rate or blood pressure was observed.

Blood Pressure↗
PubMed1994

In vitro and in vivo evidence of neurotensin release from preganglionic axon terminals in the stellate ganglion of the cat.

We have previously shown that the neurotensin (NT) store in preganglionic axon terminals of the cat stellate ganglion (SG) is reversibly depleted by prolonged preganglionic stimulation. The present study addresses the questions of whether the preganglionic axon terminals release NT in response to depolarizing stimuli in vitro and whether in vivo NT is released by the tonic firing of the sympathetic preganglionic neurons. Slices of the SG of the anaesthetized cat, maintained in oxygenated Ringer solution, released NT. The efflux increased when the K concentration was increased from 5 to 25 or 45 mM or when veratridine was added to the medium. In Ca-free medium, efflux was suppressed. The effect of veratridine was blocked by tetrodotoxin (TTX). In awake, freely moving cats, in which TTX was applied for 4 days to the preganglionic input of the right SG, the NT content of this ganglion doubled by comparison with the left SG. Since NT accumulates proximal to a ligature on the preganglionic input of the SG, the increased NT content is likely to result from suppression of action potential-dependent release while influx into the terminals persists. This result suggests that the steady state of the NT store in sympathetic preganglionic terminals is the result of a steady influx from the soma balanced by action potential-dependent loss, presumably release.

Action Potentials↗
PubMed1995

[The effects of stellate ganglion block on conjunctival oxygen tension and intraocular pressure in patients with retinal vein occlusion].

We evaluated the effects of stellate ganglion block (SGB) on conjunctival oxygen tension, ocular surface temperature (n = 7) and intraocular pressure (n = 18) in patients with retinal vein occlusion and other retinopathy. The conjunctival oxygen tension (PcjO2) increased from 45.6 +/- 5.0 mmHg to 76.3 +/- 19.9 mmHg in 45 minutes by SGB and then gradually returned to the control level. PcjO2 120 minutes following SGB remained still at a higher level compared with the control value. Ocular surface temperature increased from 35.1 +/- 0.3 degrees C to 35.9 +/- 0.3 degrees C 25 minutes following SGB. Intraocular pressure decreased below the control level from 15 minutes to 120 minutes by SGB following an initial temporary increase. In conclusion, we have found that SGB does increase oxygen tension in ocular tissue and decrease IOP.

Adult↗
PubMed1991

Effects of alpha adrenergic blockade during stellate ganglion stimulation on arrhythmias induced by acute myocardial ischemia in pigs.

The effects of alpha-adrenergic receptor blockade during stellate ganglion stimulation on arrhythmias induced by repeated coronary artery occlusion in pigs under spontaneous breathing were studied. Prazosin, alpha 1-receptor blocker, did not have any effect on the early ischemic dysrhythmia. Yohimbine, which selectively blocks alpha 2-receptor, significantly increased the number of premature ventricular complexes (19 +/- 3----32 +/- 2 PVC; P less than 0.01), but produced no effects on the percentage of appearance of ventricular fibrillation (VF) and ventricular tachycardia (VT). However, nonselective alpha-receptor blocker phentolamine significantly reduced the number of premature ventricular complexes (30.5 +/- 4.5----11 +/- 3 PVC; P less than 0.05), but did not affect the frequency of occurrence of VF and VT. The above results show that alpha-adrenergic mechanisms do not play any important role in the genesis of arrhythmias during ischemia in the pig model.

Adrenergic alpha-Antagonists↗
PubMedDate not supplied

Recovery of upper limb motor function in tetraplegia with stellate ganglion block treatment of reflex sympathetic dystrophy: a case report.

Recovery of motor function in spinal cord injury usually does not occur beyond 2 yr from the date of injury and is rare beyond 8 yr. We present a case of a gentleman with a right C-5 motor, left T-5 motor, bilateral T-5 sensory tetraplegia, sustained after a fall in September 1985, who developed reflex sympathetic dystrophy of his right arm. This pain failed to resolve during the next 8 yr, despite conservative treatment consisting of range of motion, contrast baths, transcutaneous electrical nerve stimulation unit, and tricyclic antidepressants. Furthermore, his pain was refractory to dorsal rhizotomy in 1987. Subsequent follow-up visits documented ongoing pain and weakness of the right arm, with a stable injury pattern. Approximately 8 yr after initial injury, the patient underwent a series of eight stellate ganglion blocks, with the surprising result of improvement in Kendall graded motor function. This improvement was enough to represent a change in the motor level of spinal cord injury from C-6 to C-7, with a resultant increase in functional abilities. The improvement of motor function after stellate ganglion blocks for treatment of reflex sympathetic dystrophy is unprecedented and indicates that its aggressive treatment in patients with myelopathies may hasten motor recovery and, thus, functional gains. Physiologic explanations for this phenomenon include (1) resolution of pain inhibition, (2) improvement in disturbed microcirculation, and (3) resolution of sympathetic inhibition of mu-motor neurons via internuncial neurons.

Arm↗
PubMed2000

Left stellate ganglion block has only small effects on left ventricular function in awake dogs before and after induction of heart failure.

Left stellate ganglion block (LSGB) results in acute sympathetic denervation of the left ventricular (LV) posterobasal wall. We investigated the effects of LSGB in chronically instrumented awake dogs before and after the induction of pacing-induced congestive heart failure. Twelve dogs were instrumented for measurement of global hemodynamics [LV pressure (LVP)], its first derivative (dP/dt), cardiac output (CO), and regional myocardial function (systolic posterobasal segment length shortening, mean velocity [SLmv]). Before the induction of heart failure (n = 12), LSGB did not affect CO [3.2+/-1.4 (control, mean +/- SD) vs. 3.3+/-1.6 L/min (LSGB, P = 0.45)] and SLmv (11.1+/-4.0 vs. 10.8+/-4.0 mm/s, P = 0.16), but slightly reduced LVP (130+/-12 vs. 125+/-14 mm Hg, P = 0.04), dP/dt(max) (3614+/-755 vs. 3259+/-644 mm Hg/s, P = 0.003) and dP/dt(min) (-3153+/-663 vs. -2970+/-725 mm Hg/s, P = 0.03). During heart failure (n = 8), global hemodynamics [CO (2.8+/-1.2 vs. 2.7+/-1.2 L/min, P = 0.04), LVP (119+/-6 vs. 112+/-9 mm Hg, P = 0.01), dP/dt(max) (1945+/-520 vs. 1824+/-554 mm Hg/s, P = 0.03) and dP/dt(min) (-2402+/-678 vs. -2243+/-683 mm Hg/s, P = 0.04)], as well as regional myocardial function, were significantly different after LSGB [SLmv] (8.0+/-3.8 vs. 6.9+/-3.4 mm/s, P = 0.02)]. In conclusion, even during heart failure, the hemodynamic changes after LSGB are small, confirming its broad margin of safety.

Anesthetics, Local↗