Side-port Needles for Stellate Ganglion Block

Abstract

When a standard hypodermic needle is used to perform a stellate ganglion block, it is necessary to withdraw it 2 to 3 mm after bony contact with the transverse process of C6 or C7 so that the injectate is deposited superficial to the longus colli muscle into the fascial plane that contains the stellate ganglion. This study evaluates a 22-gauge side-port needle to perform a stellate ganglion block. Since this needle has a side-port 2 to 4 mm proximal to the needle tip, it was found that, with the needle resting on the C6 transverse process, the local anesthetic solution was discharged superficial to the longus colli muscle into the correct fascial plane to produce stellate ganglion block. Using criteria established by the authors, the success rate with a side-port needle was 95% in 58 blocks performed on patients where diagnostic stellate blocks were clinically indicated. Observations included the presence of Horner9s syndrome, change in skin temperature on the ipsilateral upper extremity, and, in some subjects, the effect of block on the ipsilateral and contralateral psychogalvanic skin reflex. The authors feel this needle has advantages over standard hypodermic needles for performing stellate ganglion block.