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Kubota K, Sunada K. Changes in blood flow at the mandibular angle and Horner syndrome in a rat model of superior cervical ganglion block. J Dent Anesth Pain Med 2018; 18:105-110. [PMID: 29744385 PMCID: PMC5932997 DOI: 10.17245/jdapm.2018.18.2.105] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 03/26/2018] [Accepted: 03/28/2018] [Indexed: 11/15/2022] Open
Abstract
Background A stellate ganglion block (SGB) causes increased blood flow in the maxillofacial region, exhibiting the potential for regenerative effects in damaged tissue. The focus of this study was to understand the efficacy of SGB for regenerative effects against nerve damage. A rat model of the superior cervical ganglion block (SCGB) was created instead of SGB, and facial blood flow, as well as sympathetic nervous system function, were measured. Methods A vertical incision was made on the left side of the neck of a Wistar rat, and a 5-mm resection of the superior cervical ganglion was performed at the back of the bifurcation of the internal and external branches of the left common carotid artery. Blood flow in the skin at the mandibular angle and mean facial temperature were measured using a laser-Doppler blood flow meter and a thermographic camera, respectively, over a 5-week period after the block. In addition, the degree of ptosis and miosis were assessed over a period of 6 months. Results The SCGB rat showed significantly higher blood flow at the mandibular angle on the block side (P < 0.05) for 3 weeks, and significantly higher skin temperature (P < 0.05) for 1 week after the block. In the SCGB rat, ptosis and miosis occurred immediately after the block, and persisted even 6 months later. Conclusions SCGB in rats can cause an increase in the blood flow that persists over 3 weeks.
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Affiliation(s)
- Kazutoshi Kubota
- Department of Dental Anesthesiology, Nippon Dental University School of Life Dentistry at Tokyo, Tokyo, Japan
| | - Katsuhisa Sunada
- Department of Dental Anesthesiology, Nippon Dental University School of Life Dentistry at Tokyo, Tokyo, Japan
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Shionoya Y, Sunada K, Shigeno K, Nakada A, Honda M, Nakamura T. Can nerve regeneration on an artificial nerve conduit be enhanced by ethanol-induced cervical sympathetic ganglion block? PLoS One 2017; 12:e0189297. [PMID: 29220373 PMCID: PMC5722367 DOI: 10.1371/journal.pone.0189297] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Accepted: 11/22/2017] [Indexed: 11/27/2022] Open
Abstract
This study aimed to determine whether nerve regeneration by means of an artificial nerve conduit is promoted by ethanol-induced cervical sympathetic ganglion block (CSGB) in a canine model. This study involved two experiments—in part I, the authors examined the effect of CSGB by ethanol injection on long-term blood flow to the orofacial region; part II involved evaluation of the effect of CSGB by ethanol injection on inferior alveolar nerve (IAN) repair using polyglycolic acid-collagen tubes. In part I, seven Beagles were administered left CSGB by injection of 99.5% ethanol under direct visualization by means of thoracotomy, and changes in oral mucosal blood flow in the mental region and nasal skin temperature were evaluated. The increase in blood flow on the left side lasted for 7 weeks, while the increase in average skin temperature lasted 10 weeks on the left side and 3 weeks on the right. In part II, fourteen Beagles were each implanted with a polyglycolic acid-collagen tube across a 10-mm gap in the left IAN. A week after surgery, seven of these dogs were administered CSGB by injection of ethanol. Electrophysiological findings at 3 months after surgery revealed significantly higher sensory nerve conduction velocity and recovery index (ratio of left and right IAN peak amplitudes) after nerve regeneration in the reconstruction+CSGB group than in the reconstruction-only group. Myelinated axons in the reconstruction+CSGB group were greater in diameter than those in the reconstruction-only group. Administration of CSGB with ethanol resulted in improved nerve regeneration in some IAN defects. However, CSGB has several physiological effects, one of which could possibly be the long-term increase in adjacent blood flow.
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Affiliation(s)
- Yoshiki Shionoya
- Department of Dental Anesthesia, Nippon Dental University Hospital at Tokyo, Japan
- * E-mail:
| | - Katsuhisa Sunada
- Department of Dental Anesthesiology, Nippon Dental University School of Life Dentistry at Tokyo, Tokyo, Japan
| | - Keiji Shigeno
- Department of Bioartificial Organs, Institute for Frontier Medical Science, Kyoto University, Kyoto, Japan
| | - Akira Nakada
- Department of Bioartificial Organs, Institute for Frontier Medical Science, Kyoto University, Kyoto, Japan
| | - Michitaka Honda
- Department of Bioartificial Organs, Institute for Frontier Medical Science, Kyoto University, Kyoto, Japan
| | - Tatsuo Nakamura
- Department of Bioartificial Organs, Institute for Frontier Medical Science, Kyoto University, Kyoto, Japan
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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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Tsujimoto G, Sunada K, Nakamura T. Effect of cervical sympathetic ganglionectomy on facial nerve reconstruction using polyglycolic acid-collagen tubes. Brain Res 2017; 1669:79-88. [DOI: 10.1016/j.brainres.2017.05.028] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 05/24/2017] [Accepted: 05/26/2017] [Indexed: 01/21/2023]
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Moon HS, Chon JY, Lee SH, Ju YM, Sung CH. Long-term Results of Stellate Ganglion Block in Patients with Olfactory Dysfunction. Korean J Pain 2013; 26:57-61. [PMID: 23342209 PMCID: PMC3546212 DOI: 10.3344/kjp.2013.26.1.57] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2012] [Revised: 12/20/2012] [Accepted: 12/21/2012] [Indexed: 12/03/2022] Open
Abstract
Background Olfactory dysfunction, including anosmia and hyposmia is difficult to treat. Although the mechanism is not well known, stellate ganglion block (SGB) is used to treat olfactory dysfunction. There are no prior studies on the long-term effects of SGB on olfactory dysfunction. The purpose of this study was to evaluate the continuity of therapeutic effects and patient satisfaction with SGB treatment. Methods This was a follow-up study carried out via a telephonic survey. The olfactory function of the patient was evaluated using a visual analog scale (VAS). We checked VAS three times: VAS-I (pre-treatment VAS), VAS-A (post-treatment VAS), and VAS-C (VAS at follow up telephone survey). We divided the subjects into 2 groups according to their responsiveness to SGB: the responsive (R group) and the unresponsive groups (UR group). Patient satisfaction was evaluated using a Likert scale. Results Out of the 40 subjects, 37 responded to the telephone survey. In the UR group, there was difference in the olfactory function. However, in the R group, there were significant VAS differences; VAS-I was 9.6 ± 0.7, VAS-A was 5.1 ± 4.2, and VAS-C was 2.7 ± 2.7 (P < 0.05). On the Likert scale, patient satisfaction was as follows: grade 1, 17 patients (45.9%); grade 2, 6 patients (16.2%); grade 3, 6 patients (16.2%); and grade 4, 8 patients (21.6%). Conclusions SGB is a safe, long-lasting, and effective therapeutic modality for olfactory dysfunction treatment.
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Affiliation(s)
- Ho Sik Moon
- Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Redistribution of Tissue Blood Flow After Stellate Ganglion Block in the Rabbit. Reg Anesth Pain Med 2009; 34:553-6. [DOI: 10.1097/aap.0b013e3181b4c505] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Moon HS, Lee HJ, Sung CH, Lim SJ, Choi JH. The Efficacy of Stellate Ganglion Block in Sensorineural Anosmia Patients Unresponsive to Steroid Therapy. Korean J Pain 2007. [DOI: 10.3344/kjp.2007.20.2.154] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Ho Sik Moon
- Department of Anesthesiology and Pain Medicine, St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Hae Jin Lee
- Department of Anesthesiology and Pain Medicine, St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Choon Ho Sung
- Department of Anesthesiology and Pain Medicine, St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Su Jin Lim
- Department of Anesthesiology and Pain Medicine, St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Jin Hwan Choi
- Department of Anesthesiology and Pain Medicine, St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
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Sunderam S, Osorio I. Mesial temporal lobe seizures may activate thermoregulatory mechanisms in humans: an infrared study of facial temperature. Epilepsy Behav 2003; 4:399-406. [PMID: 12899860 DOI: 10.1016/s1525-5050(03)00116-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Facial temperature T(f), an important link in cerebral thermoregulation and an ignored index of autonomic activity, was studied in three patients with mesial temporal epilepsy. Sets of infrared images were obtained automatically during seizures and also hourly, round-the-clock. For each patient, scan sets were sorted into: (1) ictal; (2) interictal with negligible motion; and (3) interictal with motion. Comparisons of mean, variance, and trend in each scan set among these groups showed considerable variability. However, significant trends in T(f) occurred (P<0.05) in two-thirds of seizures in one patient, three-fourths in another, and two-ninths in the third, consisting of steady decreases in T(f) beginning at peak seizure intensity R(max) and continuing into the postictus. Maximal ictal T(f) was greater than interictal T(f) (P<0.05), but it negatively correlated with R(max) in two subjects. The ictal changes in T(f), which may have a homeostatic role, suggest activation of thermoregulatory mechanisms during mesial temporal seizures.
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Affiliation(s)
- Sridhar Sunderam
- Flint Hills Scientific L.L.C., 5020 West 15th Street, Suite A, Lawrence, KS 66049, USA
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Sze DY, Mackey SC. MR guidance of sympathetic nerve blockade: measurement of vasomotor response initial experience in seven patients. Radiology 2002; 223:574-80. [PMID: 11997570 DOI: 10.1148/radiol.2231010751] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The authors performed sympathetic nerve blockades in seven patients with peripheral ischemia and possible autonomic dysfunction. Magnetic resonance (MR) imaging was used to guide needle placement, to monitor distribution of injected agents, and to measure increases in blood flow, which were as much as 10-fold. MR imaging can provide both procedural imaging guidance and measurement of efficacy for sympathetic nerve blocks.
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Affiliation(s)
- Daniel Y Sze
- Division of Cardiovascular and Interventional Radiology, Department of Radiology, Stanford University Medical Center, 300 Pasteur Dr, Stanford, CA 94305, USA.
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