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An Unusual Complication of Sinus Arrest Following Right‐Sided Stellate Ganglion Block: A Case Report
Author(s) -
Saxena Ashok K.,
Saxeeeraj,
Aggarwal Bhavna,
Sethi Ashok K.
Publication year - 2004
Publication title -
pain practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 58
eISSN - 1533-2500
pISSN - 1530-7085
DOI - 10.1111/j.1533-2500.2004.04309.x
Subject(s) - medicine , anesthesia , stellate ganglion , asystole , unconsciousness , bradycardia , complication , atropine , sinus (botany) , surgery , heart rate , blood pressure , botany , biology , genus , alternative medicine , pathology
We present a case of a 29‐year‐old female patient who had presented to us for the management of her chronic right shoulder–hand pain and developed a sinus arrest following a right‐sided stellate ganglion block (RSGB). This patient on receiving a diagnostic RSGB via the anterior paratracheal (C6) approach developed sinus arrest followed by apnea and unconsciousness. On institution of resuscitative measures involving tracheal intubation, positive pressure ventilation, cardiac massage, and intravenous atropine, spontaneous cardiac activity recovered in about 3 minutes. Other signs and symptoms resolved fully in a total of 10 minutes. She had persistent postural hypotension lasting for about 24 hours requiring bed rest and was discharged about 36 hours after the procedure, without any adverse sequelae. As the sinus node is supplied by the right‐sided sympathetic chain, its blockade probably resulted in unopposed parasympathetic activity leading to asystole. Available evidence of the role of right stellate ganglion in regulation of cardiac electrophysiology and functioning is also discussed.