Comparative Study of Fluoroscopy vs Ultrasound Guided Stellate Ganglion Block

ABSTRACT

Introduction: Stellate ganglion block (SGB) is used for thetreatment of many vascular disorders and sympatheticallymediated pain including pain of head, neck, cancer, phantom,postherpetic neuralgia, cardiac arrythmia, orofacial pain, andvascular headache. Various modalities to localize stellateganglion use of fluoroscopy, computerized tomography,magnetic resonance imaging, and radionucleotide tracers.Ultrasound imaging is a best tool for SGB due to its clarity,low cost, lack of radiation and portability. In this study weaimed to compare the efficacy of fluoroscopy vs ultrasoundguided stellate ganglion block in lowering the pain usingnumeric rating scale (NRS).Material and Methods: Study was perform in 40 patientssuffering from upper limb and head and neck, neuropathicpain. The first group (Group I) received stellate ganglion blockunder ultrasound guidance while the second group (Group II)received stellate ganglion block under fluoroscopy guidance.The t-test and Man Whitney test were perform to analyses thedata.Results: The requirement of different analgesia werecomparable in both group I and group II patients. Change inpain score was maximum at immediate post-block, 1 h postblock, 6 h post block (65.84% of baseline) while change wasminimum at 48 h post-block (48.45% of baseline). The painwas significantly lower in group I from baseline as comparedto group II at all periods. Range of Ease rating score were alsolower in group I. Block was statistically achieved earlier inGroup I (4.55±0.69 min) as compared to Group II (12.60±2.56min).Conclusion: USG and fluoroscopy are both good techniquesfor stellate ganglion block, but due to less complication, earlyblocking effect time, more precise placement of medicationultrasound guided block is preferred over fluoroscopy method.