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Kawabata K, Sago T, Oowatari T, Shiiba S. Prolonged blockade of the cervical sympathetic nerve by stellate ganglion block accelerates therapeutic efficacy in trigeminal neuropathy. J Oral Sci 2021; 64:6-10. [PMID: 34789618 DOI: 10.2334/josnusd.21-0245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
PURPOSE Stellate ganglion block (SGB) is effective in treating head and neck pain and neuropathic diseases by increasing tissue blood flow through its sympatholytic effect. This study aimed to investigate the relationship between duration of cervical sympathetic nerve block by SGB and its therapeutic efficacy against trigeminal neuropathy after orthognathic surgery. METHODS Twenty-eight patients with trigeminal neuropathy were randomly assigned to two groups (mepivacaine and levobupivacaine) according to the drug used for SGB. Increased blood flow, which is a symptom of sympathetic blockade, was recorded for 180 min after SGB. Current perception threshold, warm or cool detection threshold, and tactile detection threshold were measured preoperatively, postoperatively, on day 10 after initiation of SGB, and 3 months postoperatively to compare therapeutic efficacy between the groups. RESULTS The levobupivacaine group had a significantly longer duration of increased blood flow compared with the mepivacaine group. Values of current perception threshold, warm and cool detection threshold, and tactile detection threshold significantly improved in the levobupivacaine group on day 10 after initiation of SGB and 3 months postoperatively. CONCLUSION A prolonged increase in blood flow due to long-term sympatholytic effects accelerates the therapeutic efficacy of SGB in trigeminal neuropathy.
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Affiliation(s)
- Kazune Kawabata
- Department of Science of Physical Functions, Division of Dental Anesthesiology, Kyushu Dental University
| | - Teppei Sago
- Department of Science of Physical Functions, Division of Dental Anesthesiology, Kyushu Dental University
| | - Tsuneto Oowatari
- Department of Dental Management of Compromised Patient, Kyushu Dental University
| | - Shunji Shiiba
- Department of Science of Physical Functions, Division of Dental Anesthesiology, Kyushu Dental University
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Yasuda M, Kuroda H, Suzuki K, Takahashi SS, Morimoto Y, Sanuki T. Impact of Stellate Ganglion Block on Tissue Blood Flow/Oxygenation and Postoperative Mandibular Nerve Hypoesthesia: A Cohort Study. J Oral Maxillofac Surg 2021; 80:266.e1-266.e8. [PMID: 34587486 DOI: 10.1016/j.joms.2021.08.161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 08/15/2021] [Accepted: 08/18/2021] [Indexed: 11/17/2022]
Abstract
PURPOSE Although a stellate ganglion block (SGB) increases tissue blood flow in the mandibular region, the change in tissue oxygenation after SGB and therapeutic effect of SGB for postoperative mandibular nerve hypoesthesia remain to be established. The study aim was to measure the change in tissue oxygenation in the mandibular region after SGB. METHODS To determine the variation in tissue oxygenation in the mandibular region, the tissue oxygen index (TOI; percentage of oxygenated hemoglobin in the total hemoglobin) was measured at the skin near the mental foramen bilaterally, at the primary site of unilateral SGB, achieved using 6 mL of 1% lidocaine hydrochloride, for the treatment of bilateral postoperative mandibular nerve injury. The primary outcome of this study is the temporal variation in TOI after SGB (0.5, 1, 5, 10, 15, 20, and 25 minutes after SGB), and the control group in this study is the TOI at the end of SGB injection (0 minute). All data are expressed as the mean ± standard deviation and 95% confidence interval (CI). Repeated-measures analysis of variance with Dunnett's test was used to determine parametric statistical significance. A P-value <.05 was considered statistically significant. RESULTS Thirteen patients were enrolled in this study. On both the blocked and contralateral side, the TOI was significantly increased compared to that before SGB (ΔTOI at 15 minute after SGB, 5.87 ± 2.89%, P < .001, 95% CI: 4.122 to 7.617% in the blocked side, 1.88 ± 2.73%, P = .005, 95% CI: 1.877 to 2.725% in the contralateral side). CONCLUSIONS Unilateral SGB using 6 mL of 1% lidocaine hydrochloride results in an increase in tissue oxygenation in the mandibular region. Based on these findings, we hypothesize that a series of SGBs may contribute to a more rapid recovery of postoperative trigeminal nerve injury.
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Affiliation(s)
- Michiko Yasuda
- Postdoctoral Fellow, Department of Dental Anesthesiology, Kanagawa Dental University, Yokosuka, Japan
| | - Hidetaka Kuroda
- Senior Lecturer, Department of Dental Anesthesiology, Kanagawa Dental University, Yokosuka, Japan.
| | - Kenji Suzuki
- Associate Professor, Department of Oral and Maxillofacial Surgery, Kanagawa Dental University, Yokosuka, Japan
| | - Shun-Suke Takahashi
- Professor, Department Head, Department of Pharmacology, Kanagawa Dental University, Yokosuka, Japan
| | - Yoshinari Morimoto
- Professor, Department Head, Department of Geriatric Dentistry, Kanagawa Dental University, Yokosuka, Japan
| | - Takuro Sanuki
- Professor, Department Head, Department of Dental Anesthesiology, Kanagawa Dental University, Yokosuka, Japan
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Sago T, Takahashi O, Ogawa M, Kawabata K, Matsukawa I, Shiiba S. Effects of stellate ganglion block on postoperative trigeminal neuropathy after dental surgery: a propensity score matching analysis. Sci Rep 2020; 10:13463. [PMID: 32778742 PMCID: PMC7417992 DOI: 10.1038/s41598-020-70533-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 07/27/2020] [Indexed: 11/17/2022] Open
Abstract
This study aimed to evaluate the effects of stellate ganglion block (SGB) on postoperative trigeminal neuropathy (TNP) after dental surgery. This was a retrospective study based on the medical records of all patients with postoperative TNP at Kyushu Dental University Hospital from 2014 to 2019. Patients were divided into the SGB group (received SGB) and non-SGB group (did not receive SGB). We evaluated the severity of TNP at 3 months after surgery and the incidence rate of abnormal sensations. Abnormal sensations were counted using patients’ reports of uncomfortable symptoms during the treatment, including dysaesthesia, allodynia, and hyperalgesia. A propensity score (PS) matching analysis was performed to evaluate these data. After PS matching, amongst others, the force equivalent values of the Semmes–Weinstein test at 3-months post-treatment were significantly lower in the SGB group than in the non-SGB group (2.00 ± 0.44 vs 2.30 ± 0.48; p < 0.05). In addition, after PS matching, the incidence rate of abnormal sensations during the treatment was significantly lower in the SGB group than in the non-SGB group (10 cases [4.7%] vs 22 cases [10.3%]; p < 0.05). Collectively, the findings support that SGB may improve the recovery from postoperative TNP and reduce the incidence rate of abnormal sensations after dental surgery.
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Affiliation(s)
- Teppei Sago
- Division of Dental Anesthesiology, Department of Science of Physical Functions, Kyushu Dental University, 2-6-1, Manazuru, Kokura-kita, Kitakyushu, Fukuoka, 803-8580, Japan.
| | - Osamu Takahashi
- Division of Oral and Maxillofacial Surgery, Department of Science of Physical Functions, Kyushu Dental University, Kitakyushu, Japan
| | - Mika Ogawa
- Section of Anesthesiology, Department of Diagnostics and General Care, Fukuoka Dental College, Fukuoka, Japan
| | - Kazune Kawabata
- Division of Dental Anesthesiology, Department of Science of Physical Functions, Kyushu Dental University, 2-6-1, Manazuru, Kokura-kita, Kitakyushu, Fukuoka, 803-8580, Japan
| | - Ibuki Matsukawa
- Division of Dental Anesthesiology, Department of Science of Physical Functions, Kyushu Dental University, 2-6-1, Manazuru, Kokura-kita, Kitakyushu, Fukuoka, 803-8580, Japan
| | - Shunji Shiiba
- Division of Dental Anesthesiology, Department of Science of Physical Functions, Kyushu Dental University, 2-6-1, Manazuru, Kokura-kita, Kitakyushu, Fukuoka, 803-8580, Japan
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Treatment modalities and risk factors associated with refractory neurosensory disturbances of the inferior alveolar nerve following oral surgery: a multicentre retrospective study. Int J Oral Maxillofac Surg 2018; 47:794-801. [PMID: 29307502 DOI: 10.1016/j.ijom.2017.10.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 08/21/2017] [Accepted: 10/03/2017] [Indexed: 12/22/2022]
Abstract
Little research has been conducted into hypoesthesia, and no studies have elucidated the risk factors for refractory hypoesthesia and compared treatment modalities. The purpose of this multicentre retrospective cohort study was to investigate the relationships between various risk factors, treatment modalities, and refractory hypoesthesia. Risk factors for refractory hypoesthesia after oral surgery were evaluated using univariate and multivariate analysis. To minimize the selection bias associated with a retrospective data analysis, a propensity score analysis was performed between the medication and non-medication groups (65 sites in each group). Moderate or severe hypoesthesia (odds ratio 13.42) and no or late administration of ATP/vitamin B12 (odds ratio 2.28) were significantly associated with refractory hypoesthesia. In the propensity score analysis, the incidence rate of refractory hypoesthesia in the medication group was lower than that in the non-medication group (P<0.001). This study demonstrated the multivariate relationships between various risk factors, treatment modalities, and refractory hypoesthesia. Moderate or severe hypoesthesia and no or late administration of ATP/vitamin B12 were significantly associated with refractory hypoesthesia. Therefore, clinicians should consider these risk factors and initiate early oral administration of ATP/vitamin B12 in cases of hypoesthesia.
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Liao CD, Rau CL, Liou TH, Tsauo JY, Lin LF. Effects of Linearly Polarized Near-Infrared Irradiation Near the Stellate Ganglion Region on Pain and Heart Rate Variability in Patients with Neuropathic Pain. PAIN MEDICINE 2017; 18:488-503. [PMID: 27452896 DOI: 10.1093/pm/pnw145] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Background Neuropathic pain associated with sympathetic overactivity can be effectively relieved by light irradiating the region near stellate ganglion (SGI), applied as an alternative to a conventional sympathetic blockade. The clinical effect of SGI on heart rate variability (HRV) and its association with pain outcomes require investigation. Objective This study attempted to identify the effects of SGI on pain outcomes and HRV indices and to determine the association between pain and HRV outcomes. Design A prospective double-blind, randomized study. Setting An outpatient pain medicine clinic. Subjects and Methods A total of 44 patients were enrolled and randomized into the experimental group ( n = 22) and control group ( n = 22). The experimental group received 12 sessions (twice weekly) of standard SGI, whereas the control group received the same protocol with sham irradiation. Pain and HRV were measured before and after each irradiation session. All outcome measures used in the first- and second-half treatment courses were analyzed. Results Pain and HRV outcome measures of the experimental group significantly improved after SGI when compared with the control group in both courses. Considering time and frequency domains, the changes in HRV in the second-half treatment course exceeded those in the first-half treatment course. Pain was significantly associated with postirradiated HRV indices ( P < 0.001). Conclusions Twelve sessions of SGI exerted time-dependent positive effects on pain and sympathovagal imbalance. HRV outcomes, including time and frequency domains, were an independent indicator of the clinical efficiency of SGI for treating pain in patients with neuropathic pain.
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Affiliation(s)
- Chun-De Liao
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chi-Lun Rau
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan.,Graduate Institute of Injury Prevention and Control, Taipei Medical University, Taipei, Taiwan
| | - Tsan-Hon Liou
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan.,Graduate Institute of Injury Prevention and Control, Taipei Medical University, Taipei, Taiwan.,School of Gerontology and Health Management, Taipei Medical University, Taipei, Taiwan
| | - Jau-Yih Tsauo
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Li-Fong Lin
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan.,School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
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Yamamoto T, Fujii-Abe K, Fukayama H, Kawahara H. Hypoesthesia associated with mandibular movement after sagittal split ramus osteotomy. Oral Maxillofac Surg 2017; 21:313-319. [PMID: 28584916 DOI: 10.1007/s10006-017-0633-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 05/22/2017] [Indexed: 06/07/2023]
Abstract
PURPOSE This retrospective study investigated the relationship between the degree of neurosensory disturbance (NSD) and mandibular movement distance after sagittal split ramus osteotomy (SSRO) and assessed sensory recovery. METHODS Lower lip hypoesthesia was evaluated at 1 week, 1 month, and 2 months after SSRO in 38 patients categorized according to the distance of mandibular movement: S group (0-7 mm; n = 17, 4 males and 13 females) and L group (7-14 mm; n = 21, 7 males, 14 females). Symptoms were evaluated by visual analog scale (VAS), tactile-threshold (SW) test, static 2-point discrimination (s-2PD) test, and current perception threshold (CPT) test. RESULTS The two groups did not differ significantly in gender and age. The Aβ fiber results of the CPT test differed significantly between the groups at 1 week and 1 month postsurgery (P < 0.05). There were no significant differences between the groups throughout the period in terms of VAS, SW, s-2PD, Aδ fiber, and C fiber of CPT. CONCLUSIONS Post-SSRO, the incidence of NSD in terms of tactile sensation may be greater in the L group early postoperatively. This may assist surgeons in explaining postoperative hypoesthesia to patients preoperatively.
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Affiliation(s)
- Toru Yamamoto
- Section of Anesthesiology and Clinical Physiology, Department of Oral Restitution, Division of Oral Health Sciences, Graduate School, Tokyo Medical and Dental University, 1-5-4, Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan.
| | - Keiko Fujii-Abe
- Section of Anesthesiology and Clinical Physiology, Department of Oral Restitution, Division of Oral Health Sciences, Graduate School, Tokyo Medical and Dental University, 1-5-4, Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Haruhisa Fukayama
- Section of Anesthesiology and Clinical Physiology, Department of Oral Restitution, Division of Oral Health Sciences, Graduate School, Tokyo Medical and Dental University, 1-5-4, Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Hiroshi Kawahara
- Department of Dental Anesthesiology, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi-ku, Yokohama-shi, Kanagawa, 230-0062, Japan
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Amino M, Yoshioka K, Shima M, Okada T, Nakajima M, Furusawa Y, Kanda S, Inokuchi S, Tanabe T, Ikari Y, Kamada T. Changes in arrhythmogenic properties and five-year prognosis after carbon-ion radiotherapy in patients with mediastinum cancer. Ann Noninvasive Electrocardiol 2017; 23. [PMID: 28590042 DOI: 10.1111/anec.12468] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 04/27/2017] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION Carbon-ion irradiation of rabbit hearts has improved left ventricular conduction abnormalities through upregulation of gap junctions. However, to date, there has been no investigation on the effect of carbon-ion irradiation on electrophysiological properties in human. We investigated this effect in patients with mediastinum extra-cardiac cancer treated with carbon-ion radiotherapy that included irradiating the heart. METHODS AND RESULTS In April-December 2009, eight patients were prospectively enrolled (including two male, aged 72.5 ± 13.0 years). They were treated with 44-72 Gray equivalent (GyE), with their hearts exposed to 1.3-19.1 GyE. High-resolution ambulatory electrocardiography was performed before and after radiotherapy to investigate arrhythmic events, late potentials (LPs), and heart rate variability. Five patients had pre-existing premature ventricular contraction (PVC)/atrial contraction (PAC) or paroxysmal atrial fibrillation (PAF)/AF; after irradiation, this improved in four patients with PVC/PAF/AF and did not deteriorate in one patient with PAC. Ventricular LP findings did not deteriorate and improved in one patient. In eight cases with available atrial LP findings, there was no deterioration, and two patients showed improvements. The low frequency/high frequency ratio of heart rate variability improved or did not deteriorate in the six patients who received radiation exposure to the bilateral stellate ganglions. During the five-year follow-up for the prognosis, six of the eight patients died because of cancer; there was no history of hospitalization for cardiac events. CONCLUSION Although this preliminary study has several limitations, carbon-ion beam irradiation to the heart is not immediately cardiotoxic and demonstrates consistent signals of arrhythmia reduction.
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Affiliation(s)
- Mari Amino
- Department of Cardiovascular Medicine, Tokai University, Isehara, Japan
| | - Koichiro Yoshioka
- Department of Cardiovascular Medicine, Tokai University, Isehara, Japan
| | - Makiyoshi Shima
- Department of Cardiovascular Medicine, Tokai University, Isehara, Japan
| | - Tohru Okada
- Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Mio Nakajima
- National Institute of Radiological Sciences, Inage, Japan
| | | | - Shigetaka Kanda
- Department of Cardiovascular Medicine, Tokai University, Isehara, Japan
| | - Sadaki Inokuchi
- Department of Critical Care and Medicine, Tokai University, Isehara, Japan
| | | | - Yuji Ikari
- Department of Cardiovascular Medicine, Tokai University, Isehara, Japan
| | - Tadashi Kamada
- National Institute of Radiological Sciences, Inage, Japan
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Olfactory ensheathing cell transplantation inhibits P2X4 receptor overexpression in spinal cord injury rats with neuropathic pain. Neurosci Lett 2017; 651:171-176. [DOI: 10.1016/j.neulet.2017.04.060] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2017] [Revised: 04/11/2017] [Accepted: 04/27/2017] [Indexed: 12/13/2022]
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Liao CD, Tsauo JY, Chen HC, Liou TH. Efficacy of Stellate Ganglion Blockade Applied with Light Irradiation: A Systemic Review and Meta-analysis. Am J Phys Med Rehabil 2017; 96:e97-e110. [PMID: 28118275 DOI: 10.1097/phm.0000000000000675] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Stellate ganglion block has mostly been used to relieve symptoms of neuropathic pain; several potential complications have been reported. Noninvasive stellate ganglion block application using light irradiation (SG-LI) can be used as an alternative to conventional injection blockades. Based on the variety of application protocols among previous studies, it was needed to further identify the clinical efficacy of SG-LI in managing neuropathic pain or other disorders associated with sympathetic hyperactivity. DESIGN A comprehensive search of online databases was performed to identify experimental or observational studies reporting the efficacy of SG-LI in treating patients with disorders requiring sympatholytic management. The included studies were subjected to a meta-analysis and risk-of-bias assessment. RESULTS Twenty-one experimental studies with a Physiotherapy Evidence Database score of 6/10 and 5 observational studies with a Newcastle-Ottawa scale score of 7/9 were included in the analysis. A significant effect on pain relief favoring SG-LI was identified at a standard mean difference (SMD) of -2.05 [95% confidence interval (CI), -2.49 to -1.61; P < 0.00001]. Similar effects favoring SG-LI were found in peripheral blood flow (SMD, 1.26; 95% CI, 0.26-2.25; P = 0.01) and skin temperature (SMD, 1.31; 95% CI, 0.55, 2.08; P = 0.0007). CONCLUSIONS Stellate ganglion block application using light irradiation effectively relieves pain of various etiologies and successfully induces a sympatholytic response. Stellate ganglion block application using light irradiation may be a valuable addition to the contemporary pain management armamentarium.
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Affiliation(s)
- Chun-De Liao
- From the School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University (C-DL, J-YT); and Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital (C-DL, H-CC, T-HL), Center for Evidence-Based Health Care, Shuang Ho Hospital (H-CC), Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine (H-CC, T-HL), and Graduate Institute of Injury Prevention and Control (T-HL), Taipei Medical University, Taipei, Taiwan
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Zhao HY, Yang GT, Sun NN, Kong Y, Liu YF. Efficacy and safety of stellate ganglion block in chronic ulcerative colitis. World J Gastroenterol 2017; 23:533-539. [PMID: 28210090 PMCID: PMC5291859 DOI: 10.3748/wjg.v23.i3.533] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 10/18/2016] [Accepted: 11/16/2016] [Indexed: 02/06/2023] Open
Abstract
AIM To investigate the efficacy and safety of stellate ganglion block for the treatment of patients with chronic ulcerative colitis.
METHODS A total of 120 randomly selected patients with chronic ulcerative colitis treated in Cangzhou Central Hospital from January 2014 to January 2016 were included in this study. These patients were divided into two groups: control group (n = 30), patients received oral sulfasalazine treatment; experimental group (n = 90), patients received stellate ganglion block treatment. Clinical symptoms and disease activity in these two groups were compared before and after treatment using endoscopy. Blood was collected from patients on day 0, 10, 20 and 30 after treatment. Enzyme-linked immunosorbent assay was performed to determine interleukin-8 (IL-8) level. The changes in IL-8 level post-treatment in the two groups were compared using repeated measures analysis of variance.
RESULTS After treatment, clinical symptoms and disease activity were shown to be alleviated by endoscopy in both the control and experimental groups. However, patients in the control group did not have obvious abdominal pain relief. In addition, the degree of pain relief in the experimental group was statistically better than that in the control group (P < 0.05). Ten days after treatment, IL-8 level was found to be significantly lower in the experimental group than in the control group, and the difference was statistically significant (P < 0.05). In addition, adverse events were significantly higher in the control group than in the experimental group, and the difference was statistically significant (χ2 = 33.215, P = 0.000).
CONCLUSION The application of stellate ganglion block effectively improves treatment efficacy in chronic ulcerative colitis, relieves clinical symptoms in patients, and reduces the level of inflammatory factors. Furthermore, this approach also had a positive impact on the disease to a certain extent.
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Akashi M, Hiraoka Y, Hasegawa T, Komori T. Temporal Evaluation of Neurosensory Complications After Mandibular Third Molar Extraction: Current Problems for Diagnosis and Treatment. Open Dent J 2016; 10:728-732. [PMID: 28217188 PMCID: PMC5299585 DOI: 10.2174/1874210601610010728] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 11/07/2016] [Accepted: 12/08/2016] [Indexed: 11/22/2022] Open
Abstract
Objective: This retrospective study aimed to report the incidence of neurosensory complications after third molar extraction and also to identify current problems and discuss appropriate management of these complications. Method: Patients who underwent extraction of deeply impacted mandibular third molars under general anesthesia were included. The following epidemiological data were retrospectively gathered from medical charts: type of neurosensory complication, treatment for complication, and outcome. Results: A total 369 mandibular third molars were extracted in 210 patients under general anesthesia during this study period. Thirty-one of the 369 teeth (8.4%) in 31 patients had neurosensory complications during the first postoperative week resulting from inferior alveolar nerve damage. Neurosensory complications lasting from 1 to 3 months postoperatively included 17 cases of hypoesthesia and 8 of dysesthesia in 19 patients. Five cases of hypoesthesia and 4 of dysesthesia in 5 patients persisted over 1 year postoperatively. Sixteen of 369 teeth (4.3%) in 16 patients had persistent neurosensory complications after third molar extraction under general anesthesia. Stellate ganglion block was performed in 4 patients. Early initiation of stellate ganglion block (within 2 weeks postoperatively) produced better outcomes than late stellate ganglion block (over 6 months postoperatively). Conclusion: Refractory neurosensory complications after third molar extraction often combine both hypoesthesia and dysesthesia. Current problems in diagnosis and treatment included delayed detection of dysesthesia and the lack of uniform timing of stellate ganglion block. In the future, routinely inquiring about dysesthesia and promptly providing affected patients with information about stellate ganglion block might produce better outcomes.
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Affiliation(s)
- Masaya Akashi
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kusunoki-cho 7-5-1, Chuo-ku, Kobe 650-0017, Japan
| | - Yujiro Hiraoka
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kusunoki-cho 7-5-1, Chuo-ku, Kobe 650-0017, Japan
| | - Takumi Hasegawa
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kusunoki-cho 7-5-1, Chuo-ku, Kobe 650-0017, Japan
| | - Takahide Komori
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kusunoki-cho 7-5-1, Chuo-ku, Kobe 650-0017, Japan
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Liao CD, Tsauo JY, Liou TH, Chen HC, Rau CL. Efficacy of Noninvasive Stellate Ganglion Blockade Performed Using Physical Agent Modalities in Patients with Sympathetic Hyperactivity-Associated Disorders: A Systematic Review and Meta-Analysis. PLoS One 2016; 11:e0167476. [PMID: 27911934 PMCID: PMC5135105 DOI: 10.1371/journal.pone.0167476] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Accepted: 11/15/2016] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Stellate ganglion blockade (SGB) is mainly used to relieve symptoms of neuropathic pain in conditions such as complex regional pain syndrome and has several potential complications. Noninvasive SGB performed using physical agent modalities (PAMs), such as light irradiation and electrical stimulation, can be clinically used as an alternative to conventional invasive SGB. However, its application protocols vary and its clinical efficacy remains controversial. This study investigated the use of noninvasive SGB for managing neuropathic pain or other disorders associated with sympathetic hyperactivity. MATERIALS AND METHODS We performed a comprehensive search of the following online databases: Medline, PubMed, Excerpta Medica Database, Cochrane Library Database, Ovid MEDLINE, Europe PubMed Central, EBSCOhost Research Databases, CINAHL, ProQuest Research Library, Physiotherapy Evidence Database, WorldWideScience, BIOSIS, and Google Scholar. We identified and included quasi-randomized or randomized controlled trials reporting the efficacy of SGB performed using therapeutic ultrasound, transcutaneous electrical nerve stimulation, light irradiation using low-level laser therapy, or xenon light or linearly polarized near-infrared light irradiation near or over the stellate ganglion region in treating complex regional pain syndrome or disorders requiring sympatholytic management. The included articles were subjected to a meta-analysis and risk of bias assessment. RESULTS Nine randomized and four quasi-randomized controlled trials were included. Eleven trials had good methodological quality with a Physiotherapy Evidence Database (PEDro) score of ≥6, whereas the remaining two trials had a PEDro score of <6. The meta-analysis results revealed that the efficacy of noninvasive SGB on 100-mm visual analog pain score is higher than that of a placebo or active control (weighted mean difference, -21.59 mm; 95% CI, -34.25, -8.94; p = 0.0008). CONCLUSIONS Noninvasive SGB performed using PAMs effectively relieves pain of various etiologies, making it a valuable addition to the contemporary pain management armamentarium. However, this evidence is limited by the potential risk of bias.
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Affiliation(s)
- Chun-De Liao
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
| | - Jau-Yih Tsauo
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Tsan-Hon Liou
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
- Graduate Institute of Injury Prevention and Control, Taipei Medical University, Taipei, Taiwan
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Hung-Chou Chen
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
- Center for Evidence-Based Health Care, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chi-Lun Rau
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
- Graduate Institute of Injury Prevention and Control, Taipei Medical University, Taipei, Taiwan
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