RT Journal Article
SR Electronic
T1 Delayed Severe Airway Obstruction Due to Hematoma Following Stellate Ganglion Block
JF Regional Anesthesia & Pain Medicine
JO Reg Anesth Pain Med
FD BMJ Publishing Group Ltd
SP 516
OP 519
DO 10.1136/rapm-00115550-199823050-00016
VO 23
IS 5
A1 Mishio, Mutsuo
A1 Matsumoto, Tsutomu
A1 Okuda, Yasuhisa
A1 Kitajima, Toshimitsu
YR 1998
UL http://rapm.bmj.com/content/23/5/516.abstract
AB Background and Objectives Delayed onset of airway obstruction following stellate ganglion block (SGB) may be life threatening. We treated a patient who developed a severe airway obstruction caused by a large hematoma several hours after an SGB.Methods A 62-year-old woman suffering from sudden deafness developed dyspnea 2 hours after undergoing her fourth SGB, and evidenced swelling and tenderness in her anterior neck and chest. Her pharyngolaryngeal tissues were edematous, and the glottis was markedly narrowed. Computed tomograms and magnetic resonance images revealed a large soft tissue mass extending from the first cervical vertebra to the diaphragm.Results Surgical tracheotomy was performed to maintain her airway. Swelling of the vocal cord disappeared on the eleventh day after the operation.Conclusions We believe that the SGB needle injured the vertebral artery and caused massive hemorrhage anterior to the cervical vertebra, subsequently inducing pharyngolaryngeal edema by obstructing the venous and lymphatic drainage of the cervical region.