Open AccessComplications associated with stellate ganglion nerve block: a systematic review
Author(s) -
Vasudha Goel,
Amol Patwardhan,
Mohab Ibrahim,
Carol Howe,
David M. Schultz,
Hariharan Shankar
Publication year - 2019
Publication title -
regional anesthesia and pain medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.623
H-Index - 109
eISSN - 1532-8651
pISSN - 1098-7339
DOI - 10.1136/rapm-2018-100127
Subject(s) - medicine , fluoroscopy , sedation , adverse effect , complication , nerve block , systematic review , discitis , surgery , ultrasound , anesthesia , radiology , medline , magnetic resonance imaging , political science , law
Stellate ganglion nerve blockade (SGNB) is a vital tool in our armamentarium for the treatment of various chronic pain syndromes. SGNB can be performed using the traditional landmark-based approach, or with image guidance using either fluoroscopy or ultrasound. In this review, we systematically analyzed reported SGNB-related complications between 1990 and 2018. Seven databases were queried for SGNB between January 1, 1990 and November 27, 2018. Search results of the complications associated with SGNB were reported as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations. Out of a total of 1909 articles, 67 articles met our inclusion criteria, yielding 260 cases with adverse events. In 134 of the 260 (51.5%) cases, SGNB was performed with image guidance. Sixty-four (24.6%) and 70 (26.9%) of the complication cases reported the use of ultrasound and fluoroscopy guidance, respectively. One hundred and seventy-eight (68.4%) patients had medication-related or systemic side effects, and 82 (31.5%) had procedure-related or local side effects. There was one report of death due to massive hematoma leading to airway obstruction. There was one case report of quadriplegia secondary to pyogenic cervical epidural abscess and discitis following an SGNB. Complications following SGNB have been reported with both landmark-based techniques and with imaging guidance using fluoroscopy or ultrasound. In our systematic review, most adverse events that were reported occurred during or shortly after SGNB. Vigilance, American Society of Anesthesiologists standard monitors for conscious sedation, and accessibility to resuscitation equipment are vital to the safe performance of SGNB.