Abstract No. : ABS2262: Ultrasound guided continuous stellate ganglion block in peripheral vascular disease of upper limb - A case series

Abstract

Background and Aims:Stellate ganglion block relieves pain and improves perfusion in peripheral vascular disease(PVD) of upper limbs. Single shot stellate ganglion block often provides only short-term relief and repeated blocks are associated with tissue or neural damage and infections. Non-availability/affordability limits the use of thermal radiofrequency nerve ablation of the stellate ganglion.We report our experience of managing 46 cases of PVD of upper limb with continuous stellate ganglion block(CSGB).Methods:Six cases of PVD of left upper limb who presented with severe ischemic neuropathic pain and blackish discoloration of fingers were treated with ultrasound guided CSGB with infusion of 0.125% of bupivacaine at 5ml per hour for 5 days. All patients were assessed for intensity of pain using numerical rating scale (NRS), change of colour and peripheral pulsations before the procedure and 2, 4, 12 and 24 weeks after the procedure.Results:All the patients reported significant reduction in NRS scores, improvement in skin colour, healing of gangrenous lesions and return of peripheral pulsations at follow up visits.Conclusion:Continuous catheter infusion not only provides more sustained pain relief and emerges as a cost effective option in improving perfusion and aid wound healing.