Keywords: Comfort, switching, stellate ganglion block, ultrasound, therapy
Abstract:Modern people are generally facing greater pressure, which mainly stems from many factors such as work, study, life, and family. These stresses can lead to symptoms such as headaches, dizziness, insomnia, anxiety, and other symptoms that cause discomfort in all aspects of the human body. The deep neck of the human body, where tiny neural networks converge on each side, may seem inconspicuous, but it is the "switch" that governs the comfort of the human body, manages common diseases and symptoms associated with all populations, and plays an important role in regulating the body's autonomic function [1]. Autonomic nerves include sympathetic and parasympathetic nerves, which are responsible for the daytime and nighttime state of the human body, respectively. Under normal circumstances, the sympathetic and parasympathetic nerves perform their respective duties, do not affect each other, and jointly regulate the physiological functions of the human body. However, when a lot of stress or negative emotions accumulate for a long time, our nerves will be in a state of tension, which will lead to autonomic dysfunction, which will affect the comfort of the human body, and through the blocking and adjustment of the switch (stellate ganglia), it can quickly restore its normal vitality state.
Miraculous stellate ganglia
When we are faced with a lot of stress or negative emotions for a long time can not be relieved, it will lead to our body parts are very uncomfortable, then we need to play a role in regulating through a "switch", and this switch is the stellate ganglia, she is hidden on both sides of our neck, of course, you can't touch her, we need to see her through professional ultrasound instruments, because its appearance resembles a "star" under the ultrasound image, so it is called the stellate ganglia.
She's part of the sympathetic nervous system, and you might be wondering, what is the sympathetic nervous system? Actually, we have two major generals in our body, the sympathetic nervous system and the parasympathetic nervous system, which belong to the autonomic nervous system. The sympathetic nervous system is excited like a lively big boy, full of energy and high excitement, as if there is endless energy all over your body, at this time your breathing is short, your eyes are big, your heart is pounding, and even the hairs on your body are erect. When we are ready to fall asleep, the parasympathetic nerve will slow down our heartbeat, breathe smoothly, and the whole body will become relaxed, and the body will gradually enter a state of relaxation and rest, like a dream. Under normal circumstances, the sympathetic and parasympathetic nerves, which have opposite functions, balance and restrain each other [2], and there is a relationship between the two that are mutually antagonistic and cooperative, forming a pair of twin sisters who cooperate tacitly, so that our bodies can cope well with joys, sorrows, and sorrows, and always be full of vitality.
Because she not only participates in regulating people's eye muscle activity, regulating pupil opening and contraction, and managing the amount of sweat secretion, but also participates in regulating our sleep depth, managing important physiological activities such as endocrine, heart beat, and vasodilation. In fact, she is also an auto-neuroendocrine transportation hub, which is not controlled by the human brain command, and is not subject to military orders, and she can also control the vascular nerve function on its own, and through repeated stimulation of it, it can play a role in the feedback regulation of the nervous, vascular, and endocrine networks in various parts of the body [3,4,5]. That's what makes her so magical.
Advantages over traditional stellate ganglion block ultrasound
Traditional stellate ganglion block often requires manual compression of the neck, separation of the jugular arteries and veins, patients have a strong sense of suffocation, and repeated blind puncture to find bone landmarks Patients are prone to nervousness, poor puncture experience, and large dosage, many side effects, etc., which should not be widely promoted in clinical practice.
The advantages of ultrasound are mainly reflected in 1. Safety: ultrasound-guided stellate ganglion block treatment can be carried out under real-time monitoring, clearly showing the puncture path and depth, and avoiding damage to surrounding important tissues, such as carotid artery, vagus nerve, thyroid, supraclavicular artery, lung apex, vertebral artery, recurrent laryngeal nerve, etc. 2. Accuracy: Ultrasound guidance can accurately display the location of the stellate ganglion to ensure that the drug is accurately injected into the target area, improve the treatment effect, and reduce the occurrence of complications. 3. Minimally invasive: ultrasound-guided stellate ganglion block treatment does not require surgery, only needs to be carried out by injection, and the postoperative recovery is fast and the pain is mild[5].
The course of ultrasound-guided stellate ganglion block therapy
Ultrasound is the third eye of modern doctors, after doing a good job of pre-operation education, the doctor will disinfect the skin of your neck, and then use a hair-thick puncture needle to accurately select the puncture approach under ultrasound guidance, real-time monitoring of the puncture path and depth, the doctor will skillfully avoid the adjacent blood vessels, For important tissues such as nerves and pleura, when the puncture needle reaches the target target, the doctor will accurately inject the treatment drug around the nerve, which takes about 1 minute, and the treatment drug is mainly local anesthetic, without other complex components. This treatment greatly reduces the risk and makes your treatment safer and more comfortable. See Figures (1, 2)
Figure 1
Figure 2
Figure 3
When there is blurred vision, bloodshot eyes, slightly sunken eyeballs, obstructed nasal ventilation, ruddy face, slight fever, and sometimes a little dizziness on the treated side 2-3 minutes after treatment, these symptoms are normal manifestations of the effect of the drug, and there is no need to worry too much, and it will return to normal in about 40 minutes. In order to achieve a good clinical treatment effect, when receiving stellate ganglion block therapy, it is usually necessary to alternate left and right treatments, 6-10 times as a course of treatment, and the number of treatments can be increased or decreased as appropriate according to the needs of the condition. See Figure (3)
Indications and contraindications for stellate ganglion block therapy
The main indications of stellate ganglion block are as follows: 1. Head diseases: such as various types of migraine, cerebral vasospasm, facial neuritis, vertigo, mandibular joint disorder syndrome, etc. 2. Systemic diseases: such as hypertension, hypothyroidism, anorexia, myasthenia gravis, chronic fatigue syndrome, etc. 3. Diseases of the five senses: such as sudden deafness, tinnitus, allergic rhinitis, floaters, mouth ulcers, Meniere's syndrome, etc. 4. Respiratory diseases: such as bronchial asthma, bronchospasm, chronic obstructive pulmonary disease, etc. 5. Circulatory system diseases: such as angina, myocardial infarction, arrhythmia, etc. 6. Diseases of internal organs: such as diseases of various organs such as heart, trachea, stomach, intestines, etc. 7. Genitourinary system diseases: such as nervous frequent urination, infertility, dysmenorrhea, etc. 8. Diseases of the body and limbs: such as cervical spondylosis, lumbar spondylosis, joint disease, etc. 9. Pain treatment: such as trigeminal neuralgia, tongue pain, oral mucosal xerosa, etc. 10. Neurodermatitis, pruritus, and chronic fatigue syndrome caused by endocrine disorders [6,7].
The main contraindications include: infection, bleeding, thrombosis at the puncture site, congenital neurological defects, neuropathy and tumors, as well as those with mental disorders who cannot cooperate. In addition, pregnancy is also a relative contraindication to stellate nerve blocks and may adversely affect the fetus.
In conclusion, ultrasound-guided cervical stellate ganglion block is a safe, effective, rapid, and minimally invasive treatment. However, it is important to note that any treatment has its indications and contraindications and cannot be achieved overnight. Therefore, when considering stellate ganglion block treatment, it is important to follow the advice of your medical professional to ensure that you choose the treatment option that is right for you.
Bibliography:
[1] Wang Le, Liu Beilei, Wu Gang. Stlate-shaped ganglia and cardiovascular disease? [J]. Chinese Journal of Cardiac Pacing and Cardiac Electrophysiology,2018,32(6):592-594. DOI:10.13333/j.cnki.cjcpe.2018.06.018.
[2] Su Yang. Study on the effect of electroacupuncture in the treatment of atrial fibrillation and the balance of autonomic nerve activity[D]. Guangdong:Guangzhou University of Traditional Chinese Medicine,2022(in Chinese).
[3] Jin Luwei, Zou Xuejun. Research progress of stellate ganglion block in the treatment of diseases[J]. Chinese Journal of Anesthesiology,2022,42(6):766-768. DOI:10.3760/cma.j.cn131073.20220117.00629.
[4] Wang Jianhua, Gao Shuqin, Bao Caiyun, et al. Clinical efficacy of balance regulation and training of neck muscles combined with ultrasound-guided stellate ganglion block in the treatment of hypertension caused by sympathetic cervical spondylosis[J]. Journal of Practical Cardiocerebropulmonary and Vascular Diseases,2021,29(9):116-121. DOI:10.12114/j.issn.1008-5971.2021.00.195.
[5] Li Xiukun, Liu Lei, Sui Mingwei. Research progress on ultrasound-guided stellate ganglion block[J]. Chinese Journal of Experimental Diagnostics,2020,24(11):1913-1915. DOI:10.3969/j.issn.1007-4287.2020.11.047.
[6] Li Jing. Clinical efficacy of acupuncture combined with ultrasound-guided stellate ganglion block in the treatment of peripheral facial paralysis[D]. Hubei:Hubei University of Traditional Chinese Medicine,2023.
[7] Ning Feihong, He Ying, Zhu Lili, et al. Clinical study on ultrasound-guided stellate ganglion combined with brachial plexus block in the treatment of cervical and shoulder syndrome[J]. Journal of Neck and Low Back Pain,2023,44(6):955-957. DOI:10.3969/j.issn.1005-7234.2023.06.013.
Funds: Shanghai Jing'an District Health Research Project Project No.: 2022MS06
Project Title: Clinical study of cervical ultrasound-guided stellate ganglion block for the relief of migraine in patients with insomnia
Project Leader: Liu Meiyue
Author: Liu Meiyue, Department of Anesthesiology, Zhabei Central Hospital, Jing'an District, Shanghai
Corresponding author: ZHANG Qing
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