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PubMed1992

[Thermographic assessments of the sympathetic blockade after stellate ganglion block (no. 3)--the block at the base of the 6th cervical transverse process].

We attempted to define effects of stellate ganglion block (SGB) at the base of 6th cervical transverse process by evaluating extent and degree of sympathetic blockade after SGB using the infrared thermography. Ten healthy volunteers (7 females, 3 males, age 26.0 years) were subjects of this study. Two different volumes (5 or 10 ml) of 1% plain mepivacaine were used (B5 group and B10 group). We performed SGB twice using two different volumes in all subjects on different day. Thermography was performed before and 30 minutes after SGB. On thenar and hypothenar, change of skin temperature in the B10 group tended to be higher compared with the B5 group. There were no significant differences in forehead or cheek temperature between the two groups. The thermographic whole hot area pattern on the ipsilateral hand after SGB in B10 group (60%) tended to be more frequent compared with the B5 group (40%). All subjects showed Horner's sign. No severe side-effect occurred in either group, but complaints of dysphagia appeared more frequently in the B10 group (80%) than in B5 group (40%). The change of skin temperature on thenar and hypothenar after B5 was significantly larger than that after the SGB at the top of the anterior tubercle of 6th cervical transverse process (P less than 0.05). In conclusion, B10 had more effect on lower cervical and upper thoracic sympathetic nerves than B5, but it also had a significant incidence of dysphagia feeling. Concerning the effect of the lower cervical and upper thoracic sympathetic block, B5 was superior to the SGB at the top of the anterior tubercle of 6th cervical transverse process.

Adult↗
PubMed1975

Non-uniform myocardial blood flow caused by stellate ganglion stimulation.

The blood flow through the anterior wall of the left ventricle has been studied during electrical stimulation of the left stellate ganglion of anesthetized dogs. The flow was continuously monitored by heated cross-thermocuple. Ganglion stimulation caused a significant increase in the flow through the outer half while producing relative ischemia of the inner half of the wall. Pretreatment with propranolol reduced regional difference of flow changes. Significantly augmented non-uniform flow changes, however, were produced by ganglion stimulation during hypertension caused by aortic constriction or by methoxamine. The results indicate non-uniform blood flow distribution which can be produced by sympathetic nerve excitation.

Animals↗
PubMed2000

Morphological features of neurons innervating different viscera in the cat stellate ganglion in postnatal ontogenesis.

Retrograde axonal transport of horseradish peroxidase (HRP) was used in this study to determine morphological parameters in the stellate ganglion (SG) in newborn, 10-, 20-day- and 1-month-old kittens. Neurons with the largest average size participated in innervation of the heart in newborn kittens and in innervation of the sternocleidomastoid muscle in other animals. The number of neurons sending their axons to target-organs also changed in postnatal ontogenesis. Regardless of the site of HRP injection at animals of all ages labeled neurons in the SG were located in certain zones on a topographical basis. Thus, it is concluded that in postnatal ontogenesis the neuronal organization of the SG changes in parallel to the increase of neuronal sizes and ganglion cross section area and practically finishes at 1 month of age.

Animals↗
PubMed1980

[The effects of the stellate ganglion electrostimulation on the coronary circulation of the dog (author's transl)].

In this study we have investigated the effects of the stellate ganglion electrostimulation on the perfusion pressure of coronary vascular bed perfused at constant flow. We always observed systemic hypertension and two kinds of response in the coronary district: vasodilatation or vasoconstriction. These responses were blocked by propranolol and phentolamine i.a. administration respectively, while both the phenomena were blocked by i.v. infection of guanethidine. These results seem to suggest that nervous sympathetic stimulation induces catecholamines release by means of either pregangliar adrenergic fibers directed to coronary vessels either postgangliar adrenergic fibres directed to the myocardium. The occurrence of vasodilatation or vasoconstriction could be explained by the prevalent stimulation of myocardial or coronary adrenoceptors.

Animals↗
PubMed1995

[A transient sinus arrest after right stellate ganglion block--assessment of autonomic function by heart rate spectral analysis].

We experienced a case of sinus arrest probably induced by right stellate ganglion block (SGB). A healthy medical student volunteered in our study of the cardiac autonomic nervous system and received the SGB. After the Holter ECG had been attached, the SGB was performed with mepivacaine 8 ml. Horner's sign was observed after about 3 minutes. A transient (15 s) sinus arrest occurred suddenly after about 6 minutes of the tilt test probably due to a vasovagal reflex, and the subject lost consciousness. From spectral analysis of the Holter ECG recording, the right SGB may be closely involved in the induction of the sinus arrest. Our present case suggests that sinus arrest may occur if a patient stands up after right SGB.

Adult↗
PubMed1992

[Three cases of irritable bowel syndrome treated with stellate ganglion block].

We examined three patients with irritable bowel syndrome (IBS) who did not respond to drug therapy and who were treated by stellate ganglion block (SGB) alone. The clinical symptoms improved by the SGB in all these three patients. There was no recurrence. The pathophysiological mechanism of this disease and the therapeutic efficacy of SGB should be elucidated with respect to the autonomic nervous, endocrine and immune systems. These results suggest that SGB therapy is effective for IBS, a typical psychosomatic disease.

Adolescent↗
PubMedDate not supplied

Autonomic variations after stellate ganglion block: are they evidence of an autonomic afference?

Sympathetic skin response and plethysomography were used to assess the sympatholytic effect of the stellate ganglion block with morphine and bupivacaine in patients affected by a sympathetic algodystrophy of the upper limb. Morphine did not show any analgesic or sympatholytic effect. The distribution of the sympatholytic effect and the clinical findings of pain relief without somatic sensory-motor impairments obtained with the local anaesthetic, support the presence of a blockade of the sympathetic efferent pathway as well as of an afferent contingent of fibres probably and mainly involved in sympathetic reflexes.

Afferent Pathways↗
PubMed1988

Slow cardioacceleration mediated by noncholinergic transmission in the stellate ganglion of the cat.

In C1-spinal, pentobarbital-anaesthetized or anemically decerebrated cats, the preganglionic input to the acutely decentralized right stellate ganglion was stimulated with 10- to 30-s strains at 20-40 Hz. Electrical stimulation consistently produced an increase in heart rate in the presence of blocking doses of hexamethonium and atropine or after depletion of acetylcholine from the preganglionic axons by prolonged low frequency stimulation in the presence of hemicholinium. The increase in heart rate had a delayed slow onset, lasted several minutes, and was abolished by propranolol or by section of the inferior cardiac nerve. The magnitude and duration of the heart rate increase were related to intensity, frequency, and duration of preganglionic stimulation. The response to stimulation of a given white ramus was progressively attenuated, and eventually irreversibly lost, during prolonged continuous stimulation of that ramus, while the response to stimulation of a different unstimulated ramus was unchanged. We conclude that the slow cardioacceleration results from a slow and prolonged excitation of postganglionic neurons by a noncholinergic transmitter released by the preganglionic axons.

Animals↗
PubMedDate not supplied

Neurotoxicological effects of trimethyltin on the stellate ganglion.

Hamsters treated with trimethyltin (TMT), 3 or 4 mg/kg IP, developed neurological symptoms, including tremor, within 24 hours. Postganglionic action potentials were recorded from isolated stellate ganglia of untreated hamsters (control ganglia) and TMT-treated hamsters (TMT ganglia). Compound action potentials (nicotinic transmission) of control and TMT ganglia were not significantly different. The afterdischarges induced by preganglionic stimulation at 30 Hz for 2 sec in the presence of 10(-3) M hexamethonium (muscarinic transmission) were significantly smaller in TMT ganglia than in control ganglia. The discharges induced by the muscarinic cholinoceptor agonist. McN-A-343, were also smaller in the TMT ganglia. Two other muscarinic processes, posttetanic potentiation and potentiation of the compound action potential by McN-A-343, were not significantly reduced in the TMT ganglia. Morphological studies of the ganglia revealed marked changes in the TMT ganglia with severe neuronal degeneration including vacuole formations and accumulations of lysosomes in the cytoplasm. These results demonstrate that TMT has marked anatomical effects on the stellate ganglion that may lead to the reduction in muscarinic cholinergic transmission.

Action Potentials↗
PubMed1979

Effects of nicotine and hexamethonium on discharges in the stellate ganglion.

The effects of nicotine and hexamethonium on postganglionic discharges elicited by tetanic preganglionic stimulation or muscarinic agonists were observed on the isolated hamster stellate ganglion. The amplitude and duration of the afterdischarges from tetanic preganglionic stimulation in hexamethonium (10-3 M) were smaller than the amplitude and duration of the afterdischarges in nicotine (10-3 M). Also, hexamethonium decreased the amplitude and duration of the afterdischarges from repetitive stimulation in the presence of nicotine. The mechanism of these effects was explored. After application of nicotine for 30 min, the discharges from McN-A-343, a muscarinic agonist, were the same as before the nicotine. Hexamethonium did not reverse the block of the single evoked potential by nicotine. The potentials during a train in the presence of hexamethonium plus atropine were the same as the potentials during a train in the presence of nicotine plus atropine. Hexamethonium did depress the McN-A-343 discharges in the presence of nicotine and also in the control solution. These results indicate that hexamethonium has a direct depressant effect on the muscarinic synaptic membrane.

(4-(m-Chlorophenylcarbamoyloxy)-2-butynyl)trimethy↗
PubMed2006

Efficacy of stellate ganglion blockade for the management of type 1 complex regional pain syndrome.

INTRODUCTION: The purpose of this study was to examine the efficacy of stellate ganglion blockade (SGB) in patients with complex regional pain syndromes (CRPS I) of their hands. METHODS: After IRB approval and patient informed consent, 25 subjects, with a clinical diagnosis of CRPS I of one hand as defined by the International Association for the Study of Pain (IASP) criteria, had three SGB's performed at weekly intervals. Laser Doppler fluxmetric hand perfusion studies were performed on the normal and CRPS I hands pre- and post-SGB therapy. No patient was included in this study if they used tobacco products or any medication or substance that could affect sympathetic function. The appropriate parametric and nonparametric data analyses were performed and a p value <0.05 was used to reject the null hypothesis. RESULTS: Symptom onset of CRPS I until the initiation of SGB therapy ranged between 3 to 34 weeks. Following the SGB series, patient pain relief was as follows: group I, 10/25 (40%) had complete symptom relief; group II, 9/25 (36%) had partial relief and group III, 6/25 (24%) had no relief. The duration of symptoms until SGB therapy was: group I, 4.6 +/- 1.8 weeks, group II, 11.9 +/- 1.6 weeks and group III, 35.8 +/- 27 weeks. Compared with the normal control hand, the skin perfusion in the CRPS I affected hand was greater in group I and decreased in groups II and III. DISCUSSION: The results of our study demonstrate that an inverse relationship exists between hand perfusion and the duration of symptoms of CRPS I. On the other hand, a positive correlation exists between SGB efficacy and how soon SGB therapy is initiated. A duration of symptoms greater than 16 weeks before the initial SGB and/or a decrease in skin perfusion of 22% between the normal and affected hands adversely affects the efficacy of SGB therapy.

Adult↗
PubMed1981

Electrocardiographic changes induced by the stellate ganglion block in normal subjects.

In order to examine the laterality of the sympathetic control of the human heart, electrocardiographic changes induced by a unilateral stellate ganglion block (SGB) were observed. 10ml of 1% lidocaine was used for the block and post-block ECG was recorded just after the appearance of Horner's sign. Patients who developed vocal hoarseness were excluded. 15 recordings of 14 subjects with right SGB and 16 recordings of 12 subjects with left SGB were used for analysis. A significant increase in the P-P interval from 0.90 +/- 0.17 sec to 0.96 +/- 0.16 sec. was observed only with right SGB and the predominance of the right side in the sympathetic nervous control of the human heart was thus demonstrated. The atrioventricular conduction time was not affected by either the right or left SGB. The QTc was slightly but significantly prolonged only by the right SGB, from 0.40 +/- 0.04 sec. to 0.43 +/- 0.04 sec. This prolongation was not large enough to support a definite conclusion and further investigations should be made.

Adult↗
PubMed2006

Comparison between neurotropin and mepivacaine for stellate ganglion injection.

Neurotropin, a nonproteinaceous extract from the inflamed skin of rabbits inoculated with vaccinia virus, is reported to decrease pain effectively when used for stellate ganglion (SG) injection. We compared the effects of neurotropin SG injection with those of mepivacaine on pain relief, as well as comparing the side effects. One hundred and eighty-eight SG injections in 15 patients (5 with postherpetic neuralgia and 10 with sudden deafness) were performed either with 1% mepivacaine 6 ml or with neurotropin 3 ml combined with saline 3 ml in turn. Fifteen min before and after the injection, the pain score, according to a visual analog scale (VAS; only in patients with postherpetic neuralgia); blood pressure; and heart rate were checked, and the number of procedures with Horner's sign was determined. VAS scores decreased significantly with both injections. Horner's sign was observed on the block side in all procedures with the mepivacaine injection, but it was seen in only 48 procedures with the neurotropin injection. Blood pressure and heart rate did not change. In conclusion, the SG injection of neurotropin decreased the VAS score in postherpetic neuralgia to the same extent as mepivacaine. The incidence of Horner's sign was significantly lower with neurotropin than with mepivacaine.

Adult↗
PubMed1992

[A 5-year-old patient with allergic diseases responsive to stellate ganglion block].

We examined a 5-year-old boy with allergic rhinitis, chronic sinusitis, atopic dermatitis, and tendency to suffer common cold, who responded to stellate ganglion block (SGB). SGB therapy was extremely effective for this patient. The result suggests that SGB therapy should be performed on patients with allergic diseases resistant to drug and diet therapy. Furthermore, the indication for nerve block therapy, such as SGB, may be extended even to pediatric patients.

Autonomic Nerve Block↗
PubMed1991

[Thermographic assessments of the sympathetic blockade by stellate ganglion block (1) Comparison between C7-SGB and C6-SGB in 40 patients].

We compared the degree in sympathetic blockade after C7-SGB (stellate ganglion block at the level of 7th vertebral transverse process) and the one after C6-SGB (SGB at the level of 6th cervical transverse process) using infrared thermography. Forty patients entered this study. C7-SGB was performed in 20 patients using 5 ml of 1% plain mepivacaine at the anterior aspect of 7th cervical transverse process, and C6-SGB in the remainder at the top of the anterior tubercle of 6th cervical transverse process. Thermography was performed before and 30 minutes after SGB. Temperature differences between right and left side after SGB were significantly larger than those before SGB on all measured sites in two groups (P less than 0.001-0.05). On the thenar, the hypothenar, the first, the second, the fourth, and the fifth finger tips, changes of skin temperature in the C7-SGB group were significantly larger than in the C6-SGB group (P less than 0.05). There were no significant differences on the forehead or the cheek in two groups. All patients showed Horner's sign. No severe side-effect occurred in either group. In conclusion, while effect of upper cervical sympathetic blockade after C7-SGB was similar to the one after C6-SGB, effect of lower cervical and upper thoracic sympathetic blockade after C7-SGB was more effective than that after C6-SGB.

Adult↗
PubMed1993

Ultrastructural localization of neurotensin immunoreactivity in the stellate ganglion of the cat.

The morphological features and cellular relationships of neurotensin-containing axon terminals were studied at light and electron microscopic levels in the cat stellate ganglion using peroxidase and immunogold immunocytochemistry. By light microscopy, neurotensin immunoreactivity was detected within thin varicose fibres distributed throughout the ganglion. Immunoreactive fibres were no longer apparent following chronic deafferentation of the ganglion indicating that they were of extrinsic origin. Ultrastructural analysis of peroxidase immunostained material confirmed the presence of neurotensin immunoreactivity within a subpopulation of axonal varicosities which made synaptic contacts with the dendrites of ganglion cells. Within labelled varicosities neurotensin immunoreactivity was found by both immunoperoxidase and immunogold methods to be concentrated within large dense core vesicles 80-120 nm in diameter. These large dense core vesicles were characteristically distant from the active zone, in keeping with a possible extrasynaptic release of the peptide.

Animals↗