Comparison of effectiveness and safety of two approaches for stellate ganglion block under ultrasound guidance
超声引导下星状神经节阻滞两种入路的有效性和安全性比较

摘要

目的 比较超声引导下星状神经节阻滞两种入路的有效性和安全性。方法 选取2023年10月1日-2024年10月31日本院100例星状神经节阻滞患者，按照随机数字表法分为研究组（改良颈外侧入路法）和对照组（经前侧入路法）两组，各50例。统计分析两组一次穿刺成功率、起效时间、霍纳综合征出现时间、穿刺不良反应发生率。结果 研究组一次穿刺成功率高于对照组（P<0.05），起效时间短于对照组（P<0.05），研究组霍纳综合征出现时间主要集中于拔针后5min，占54.00%，对照组霍纳综合征出现时间主要为拔针后2min，两组霍纳综合征出现时间比较差异有统计学意义（P<0.05）。穿刺回血、穿刺异感、喉返神经阻滞发生率均低于对照组（P<0.05）。结论 超声引导下星状神经节阻滞改良颈外侧入路较经前侧入路更能减少并发症及不良反应的发生，有望指导我院行超声引导下星状神经节阻滞入路法的选用，为临床实施星状神经节阻滞予以指导，预期治疗效果及提高患者满意度。

Abstract

Objective To compare the effectiveness and safety of two approaches for ultrasound-guided stellate ganglion block.
Methods A total of 100 patients with stellate ganglion block in our hospital from October 1, 2023 to October 31, 2024 were randomly divided into a study group (modified lateral cervical approach) and a control group (anterior approach), 50 cases in each group. The one-time puncture success rate, onset time, Horner syndrome occurrence time, and incidence of adverse reactions of puncture were statistically analyzed between the two groups.
Results The one-time puncture success rate in the study group was higher than that in the control group (P<0.05), and the onset time was shorter than that in the control group (P<0.05). The occurrence time of Horner syndrome in the study group was mainly concentrated in 5 minutes after needle removal, accounting for 54.00%, while the occurrence time of Horner syndrome in the control group was mainly 2 minutes after needle removal. The difference in the occurrence time of Horner syndrome between the two groups was statistically significant (P<0.05). The incidence of puncture blood return, puncture paresthesia, and recurrent laryngeal nerve block was lower than that in the control group (P<0.05).
Conclusion   The modified lateral cervical approach for ultrasound-guided stellate ganglion block can reduce the incidence of complications and adverse reactions compared with the anterior approach, which is expected to guide the selection of ultrasound-guided stellate ganglion block approach in our hospital, provide guidance for the clinical implementation of stellate ganglion block, and improve the expected treatment effect and patient satisfaction.