Clinical efficacy of "Shamrock" ultrasound images-guided lumbar sympathetic ganglion blockade

Abstract

Objective To evaluate the clinical efficacy of Shamrock ultrasound images-guided lumbar sympathetic ganglion blockade (LSGB). Methods Sixty patients of both sexes, aged 18-60 yr, weighing 50-70 kg, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, undergoing unilateral LSGB, were divided into groupⅠ(n=30) and group Ⅱ (n=30) using a random number table.In group Ⅰ, unilateral LSGB was performed at the L2 level under ultrasound guidance with paramedian transverse scanning.In group Ⅱ, unilateral LSGB was performed at the L2 level under ultrasound guidance with Shamrock ultrasound images.After final needle position was confirmed, 2% lidocaine 6.0 ml was administered in each patient.At 20 min before and after LSGB, the visual analogue scale scores and skin temperature of the big toe of the affected foot were recorded, and the successful blockade and visibility of important paravertebral structures on ultrasound images were recorded during puncture. Results The visual analogue scale scores were significantly lower, and the skin temperature on the affected side was significantly higher after LSGB than before LSGB in both groups (P<0.05). The important paravertebral structures such as erector spinae, quadratus lumborum, psoas major, transverse process of L2 vertebrae, and the curved edge of L2 vertebrae were visible in both groups.The visibility rate of the inferior vena cava or abdominal aorta on ultrasound images and the success rate of blockade were significantly lower in group Ⅰ than in group Ⅱ (P<0.01). Conclusion Compared with paramedian transverse scanning, LSGB has some advantages such as real-time monitoring, higher success rate of blockade, better efficacy and avoiding damage to great vessels when performed under Shamrock ultrasound image guidance. Key words: Ultrasonography; Ganglia, sympathetic; Nerve block