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Impact of Neck Position on the Probability of Common Carotid Artery Puncture During Ultrasound‐Guided Stellate Ganglion Block
Author(s) -
Park Dong Yoon,
Kang Seok,
Kang Hyo Jung,
Choi Jun Kyu,
Do Kim Jae,
Yoon Joon Shik
Publication year - 2019
Publication title -
pmandr
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.617
H-Index - 66
eISSN - 1934-1563
pISSN - 1934-1482
DOI - 10.1016/j.pmrj.2018.08.376
Subject(s) - medicine , supine position , ultrasound , common carotid artery , anatomy , internal carotid artery , carotid arteries , radiology , surgery
Background The carotid artery must be avoided during stellate ganglion block. However, information on optimal neck position during the ultrasound‐guided approach is limited. Objective To investigate the relation between the target area of the procedure and the carotid artery in different neck positions. Design Observational study. Setting Tertiary university. Participants A total of 30 sides of the neck from 18 healthy participants were included. Methods An ultrasound transducer was placed at the level of the anterior tubercle of C6 with a short‐axis view for measuring the distance from the tip of the C6 anterior tubercle to the margin of the carotid artery. The participants were first examined through ultrasonography in 3 different rotational neck positions (neutral, semicontralateral rotation, and full‐contralateral rotation), in the supine position. After changing to the lateral decubitus position, the measurement was performed again in the same 3 neck positions. Main Outcome Measures The C6 anterior tubercle to carotid distance was measured with ultrasound. Results The C6 anterior tubercle to carotid distance was the longest with full‐contralateral neck rotation ( P < .05). The distance was longer in the semicontralateral neck rotation compared with the neutral neck position ( P < .05). Supine or decubitus positions did not affect the distance. Conclusions We suggest that the full‐contralateral neck rotation posture in either the supine or decubitus position is most beneficial for avoiding damage to the carotid artery during the ultrasound‐guided stellate ganglion block. Level of Evidence Not applicable.