Anesth Pain Med.  2017 Oct;12(4):371-374. 10.17085/apm.2017.12.4.371.

A comparison between the right side and the left side of head skin in a patient who received more than 450 sessions of left stellate ganglion block: A case report

• Hong SM
• Park BC
• Song JG
• Lee GW

• KMID: 2405857
• DOI: http://doi.org/10.17085/apm.2017.12.4.371

Abstract

Stellate ganglion block (SGB) is an effective method that is used by pain clinicians to treat patients who have pain in the head, neck and arm area. SGB acts mainly by increasing regional blood flow via peripheral vasodilation and decreasing pain sensation by reducing the afferent sensory signals of the sympathetic nervous system in the region. This patient had received more than 450 sessions of left SGB continually for the past 6 years to relieve her left-sided facial pain caused by facial trauma. Out of our curiosity, we tried to obtain some objective dermatological measurements like skin elasticity, water content, and hair follicle density on her scalp and we found that the values were different between the left side of her face and the right side of her face. Here, we report the results and we want pain clinicians to know that repeated SGBs may improve skin elasticity, water content in the skin, and increase the number of hair follicles on the scalp.

Keyword

Dermatological measurements; Stellate ganglion block

MeSH Terms

Arm
Elasticity
Exploratory Behavior
Facial Pain
Hair Follicle
Head*
Humans
Methods
Neck
Regional Blood Flow
Scalp
Sensation
Skin*
Stellate Ganglion*
Sympathetic Nervous System
Vasodilation
Water
Water

Figure

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  Fig. 1 Fluoroscopic images of contrast spread after caudal epidural block. (A) Anteroposterior view of contrast spread. (B) Lateral view of contrast spread. Arrowhead: contrast spread in the epidural space.

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  Fig. 2 Comparison of transforaminal versus oblique interlaminar approach. (A) Needle entry points of transforaminal approach versus oblique interlaminar approach. (B) Initial needle entry point of right transforaminal approach. (C) Initial needle entry point of right oblique interlaminar approach.

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  Fig. 3 Fluoroscopic images of contrast spread after oblique interlaminar approach. (A) Initial entry point of right oblique L5-S1 interlaminar approach. (B) Anteroposterior view of contrast spread. (C) Lateral view of contrast spread. Arrow: a 22-G, 80-mm Tuohy needle, Arrowhead: contrast spread in the epidural space.

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