对比超声引导下经前斜角肌与经颈静脉行星状神经节阻滞的有效性及安全性

Efficacy and safety of ultrasound-guided stellate ganglion block: Comparison of through anterior scalenus muscle and through internal jugular vein

目的对比超声引导下经前斜角肌与经颈静脉行星状神经节阻滞(SGB)的有效性及安全性。方法将144例颈源性头痛患者随机分为2组,分别行超声引导下经前斜角肌SGB(前斜角肌组,n=72)和超声引导下经颈静脉SGB(颈静脉组,n=72)。比较2组阻滞成功率、霍纳征出现时间及不良反应发生率。结果前斜角肌组与颈静脉组阻滞成功率[97.22%(70/72)vs 98.61%(71/72)]、霍纳征出现时间[术后(2.18±0.96)min vs术后(1.96±0.87)min]差异均无统计学意义(P均>0.05)。前斜角肌组不良反应发生率为19.44%(14/72),颈静脉组4.17%(3/72),差异有统计学意义(P=0.01)。结论超声引导下穿过前斜角肌与穿透颈静脉行SGB均安全有效,后者穿刺时不良反应较少。

Objective To compare the efficacy and safety of ultrasound-guided stellate ganglion block (UGSGB) through anterior scalenus muscle (ASM) and through internal jugular vein (IJV). Methods Totally 144 patients with cervicogenic headache were distributed into 2 groups randomly. USSGB was performed through ASM (ASM group, n =72) or through IJV (IJV group, n =72), respectively. The ratio of successful blocks, the appearing time of Honer syndrome and the ratio of adverse reaction were compared between two groups. Results The successful block ratio was 97.22%(70/72) of ASM group and 98.61%(71/72) of IJV group, while Honer syndrome appearing times was (2.18±0.96)min and (1.96± 0.87)min after operation, respectively. There was no significant difference between 2 groups (both P >0.05). The adverse reaction ratio was 19.44%(14/72) of SCM group and 4.17%(3/72) of IJV group ( P =0.01). Conclusion USSGB through ASM approach and USSGB through IJV approach are both safe and efficient. IJV approach has less adverse reaction than SCM approach.