Medical Specialty:
Pain Management
Sample Name: Stellate Ganglion Block
Description: Complex regional pain syndrome, right upper extremity. Stellate ganglion block.
(Medical Transcription Sample Report)
PREOPERATIVE DIAGNOSIS: Complex Regional Pain Syndrome, right upper extremity.
POSTOPERATIVE DIAGNOSIS: Same.
OPERATION: Stellate ganglion block.
ANESTHESIA: Local and sedation.
COMPLICATIONS: None.
The cricoid cartilage is palpated and the fingertips are moved laterally, displacing the sternocleidomastoid and the carotid sheath laterally. Chassaignac's tubercle, the transverse process of the 6th cervical vertebra, is identified under fluoroscopic control palpated and then isolated between two palpating fingertips. Once the carotid sheath is out of the way, a 22-gauge needle is inserted perpendicularly to all planes and placed on the anterior lateral border of the C-6 vertebral body and then withdrawn 1-2 millimeters before a negative aspiration is performed for heme and CSF. Three to five milliliters of nonionic radio-opaque contrast media is injected and noted to flow over the lateral borders of the ipsilateral cervical vertebral bodies. This is followed by an injection of 10cc of Marcaine 0.25% in aliquots of 2 cc with negative aspirations between injections.
The patient tolerated the procedure well without any evidence of complications or problems. They were experiencing evidence of a Horner's sign after the block was established. They were experiencing relief from their pain after the block had set.
Keywords: pain management, chassaignac's tubercle, horner's sign, stellate ganglion block, sheath, vertebral, stellate, ganglion, cervical, block,