Impact of Neck Position on the Probability of Common Carotid Artery Puncture During Ultrasound-Guided Stellate Ganglion Block
- Authors
- Park, Dong Yoon; Kang, Seok; Kang, Hyo Jung; Choi, Jun Kyu; Kim, Jae Do; Yoon, Joon Shik
- Issue Date
- 5월-2019
- Publisher
- WILEY
- Citation
- PM&R, v.11, no.5, pp.463 - 469
- Indexed
- SCIE
SCOPUS
- Journal Title
- PM&R
- Volume
- 11
- Number
- 5
- Start Page
- 463
- End Page
- 469
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/65939
- DOI
- 10.1016/j.pmrj.2018.08.376
- ISSN
- 1934-1482
- Abstract
- Background: The carotid artery must be avoided during stellate ganglion block. However, information on optimal neck position during the ultrasound-guided approach is limited. Objective: To investigate the relation between the target area of the procedure and the carotid artery in different neck positions. Design: Observational study. Setting: Tertiary university. Participants: A total of 30 sides of the neck from 18 healthy participants were included. Methods: An ultrasound transducer was placed at the level of the anterior tubercle of C6 with a short-axis view for measuring the distance from the tip of the C6 anterior tubercle to the margin of the carotid artery. The participants were first examined through ultrasonography in 3 different rotational neck positions (neutral, semicontralateral rotation, and full-contralateral rotation), in the supine position. After changing to the lateral decubitus position, the measurement was performed again in the same 3 neck positions. Main Outcome Measures: The C6 anterior tubercle to carotid distance was measured with ultrasound. Results: The C6 anterior tubercle to carotid distance was the longest with full-contralateral neck rotation (P < .05). The distance was longer in the semicontralateral neck rotation compared with the neutral neck position (P < .05). Supine or decubitus positions did not affect the distance. Conclusions: We suggest that the full-contralateral neck rotation posture in either the supine or decubitus position is most beneficial for avoiding damage to the carotid artery during the ultrasound-guided stellate ganglion block.
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