Ultrasound guided stellate ganglion block

[@Whoisdgalt]

Hi. I am not even an anesthesiologist. I just enjoy watching the excellent videos. Thanks.

[@ninadinishrestha7882]

Finally a video with clear and complete information on ultrasound guided stellate ganglion block. Great work!

[@anesthesiadreamin]

Great content, great voice, great organization. All your videos have been exceptional. Thankyou for taking the time to make them! Cheers from Colorado🙂

[@drnajwaabdullahut6505]

Absolutly excellent video.. Thanks team.. I have being searching this type of video for long... 👏🏻👏🏻👏🏻

[@waiki8223]

Very complete and clear explanation, thank you!!

[@suprachris81]

Thank you for sharing and teaching us

[@aabotaiban]

love your way to explanation and comments.

[@Anaestheasier]

Your videos are spectacular and we would love to reference them in a new teaching toolkit for anaesthetic trainees that we are building - is there a way we can discuss this with you?

[@jimjimmy3131]

I hope you actually discussed about it.

[@Anaestheasier]

@@jimjimmy3131 we did!

[@evilo720]

Great video, thank you ~

[@Jinku325]

훌륭한 렉쳐 감사합니다.

[@TheHanswurstpeter]

Great video 👍

[@taowu4124]

非常好，谢谢。但有个问题，注射靶点应该在椎前筋膜的深层，颈长肌的表面。Very good, thank you. But there is a problem, the injection target should between the prevertebral fascia and musculus longus colli, not on the surface of the prevertebral fascia.

[@CiCiQ]

Hi, I have been doing a lot of research on this for my ptsd and reading about the positive effects it has been having along with the side effects.. I especially liked the study that the Department of Veterans Affairs mentions in their Health Services and Research Development. My question is how do I approach a doctor to receive this treatment? I don't like taking meds because most make me feel worse and walking into a pain management facility, just thinking about it, stresses me. I understand that the dual UGSGB would have to be done multiple times to truly be effective. There are centers opening all over the place looking to capitalize on this procedure and charging premium prices that are truly stellar. Since this would be a self pay procedure and because it isn't covered by insurance yet, I would like to get it but not be taken advantage of. Any guidance would be greatly appreciated.

[@dr.johnvogel3430]

If you are in the VA system, you can try to get a referral, but it will be a bitch. It would probably have to come from psych as the VA is kind of rigid that way. I get your hesitation going to a pain clinic. The first visit just needs to be a discussion. Get whatever information you need to feel more comfortable. Note I said "more". If needed, you can be given medications before the procedure if you are super anxious. Some people do really well with a single injection (C6 and C4), but they are in the minority. So many individual variables. Its not that there are centers opening to offer the procedure, but more pain specialists are offering it (along with all the other procedures they do). I only know one place that SGB is all they do.The price from $500-$3000, so shop around.

[@TheOdiousMonk]

​​​@@dr.johnvogel3430 I got this done in October for PTSD and it was a miracle, for three months. Now my symptoms are returning. But the day after treatment I had an itchy throat, so I searched potential risks for SGB, and I found Pneumothorax/collapsed lung... ! That info scared the life out of me. I got an x-ray that day just to be sure that's not what I had. I was fine. But I still can't find convincing information on how well the doctor can see your airway (during ultrasound guidance). I fear it's still high risk and feel scared to do it again. Can you tell me anything to lessen my fears regarding whether the pneumothorax and collapsed lung could happen during ultrasound-guided SGB therapy? Thank you .

[@markdzwonkiewicz2937]

Strong work! Thank you.

[@DradelHassan]

EXCELLENT PRESENTATION

[@anishwaghray3633]

Brilliant 👏🏼👏🏼

[@SleepToken29]

Can this treatment be used for long covid parosmia?

[@dr.johnvogel3430]

Yes, it is successful for treating parosmia and anosmia

[@Taybay80]

this treatment. Angina due to myocardial bridge disease. Is it suitable for this disease?

[@Disregarding]

I’m desperately trying to find somewhere local that can do this for me. I need it badly

[@remyhakobyan]

Could you please update us with your experience with bilateral stellate ganglion block; when should it be used if at all Thank you

[@remyhakobyan]

Thanks a lot for kind explanation I'm specifically interested in SGB for indications like menopause or PTSD ; do these necessitate bilateral block ?

[@dr.johnvogel3430]

There is data demonstrating superior benefit of bilateral SGB for PTSD and TBI. For safety reasons, they need to be done at least a day apart.

[@psychiatrist123]

How long the benfit wiĺl last with one injection on average

[@AB-1023]

When I got this, it was a doctor still learning how to do it. It felt like all the nerves in my neck were getting grabbed and ripped out by the fist. But on the third try it worked great Edit: after watching this I realize I risked my freakin life. The doctor was arguing with his assistant while the needle was 2 inches deep in my neck on the table Haha things work out I guess

[@Wrenwild]

Would a bilateral TOS patient be a good candidate for this procedure considering how delicate the procedure is?

[@dr.johnvogel3430]

Cervical sympathetic block will not help TOS. Better to do neurotoxin injection into the anterior scalene

[@fang9872]

is the injection location above or under prevertebral fascia？

[@dr.johnvogel3430]

Anterior to the prevertebral fascia

[@DradelHassan]

Marvelous

[@annap1191]

Is it only for diagnostic purposes. How long does any relief last for?

[@regionalanesthesiology]

Stellate ganglion block is being used for a variety of therapeutic indications (and the number seems to be growing). We use it regularly for treatment of refractory ventricular tachycardia and chronic pain syndromes of the upper limb, but it's also being used to treat anxiety and PTSD (both of which have a sympathetically-mediated component in many patients). Also hot flashes in menopause. I've also seen reports of it being used to treat covid-related anosmia (!). The local anesthetic itself only lasts for 12-15 hours, but the clinical effect seems to last much longer, often days, especially with repeated treatments. Hope that helps!

[@dr.johnvogel3430]

As stated below, it depends what condition the SGB is done for. For PTSD average length is 3-4 months. For hot flashes, closer to 6 months.

[@mrspine4405]

I'm about to get that done...

[@NYMDGRL87]

How did this go? I am considering for myself

[@mrspine4405]

@@NYMDGRL87 procedure is painful and unpleasant. Effect? Maybe 5% improvement. Nit worth the pain, risk and money if there is any shadow of chance to improve with time plus some other unconventional medicine.

[@anditaqwaPainFree]

type USG?

[@josueaguilar9049]

Hi!! Can we use electrical Stimulation??

[@dr.johnvogel3430]

Pulsed radiofrequency treatment can be used as an alternate to local anesthetic if that's what you mean by electrical stim

[@fonzarellyplay370]

Does this help with anxiety?

[@regionalanesthesiology]

Yes, a growing body of literature does support that and people I know are getting great results for both generalized anxiety disorder and PTSD. Here are some references: pubmed.ncbi.nlm.nih.gov/27739175/ pubmed.ncbi.nlm.nih.gov/34255448/ pubmed.ncbi.nlm.nih.gov/37373947/

[@nuraykocalkan6649]

how long do the effects last?

[@dr.johnvogel3430]

Highly variable, and depends on the condition being treated, but generally 3-6 months

[@Grundalizer]

Had a panic attack just watching this.

[@riorio4026]

How long does this injection last? How safe is it? Will it give you dementia or Alzheimer's in the future? Where's the proof it doesn't?

[@monkeybearmax]

Just wondering why woukd u think it would give u Alzheimer’s?

[@dr.johnvogel3430]

The duration of effect averages about 4 months. There is no reason to suspect there is any adverse effect from dialing down an over active sympathetic nervous system. Proving a negative is nearly impossible.

[@riorio4026]

Omg so many dangerous side effects.

[@dr.johnvogel3430]

Not in well trained hands

[@dorkusamericanus]

Lobotomy 2.0

[@clicheguevara5282]

Pumping an anesthetic into a nerve cluster is ENTIRELY different from removing part of the frontal lobe.

[@AnnaM-bt2je]

You’ve lived up to your name

[@djdarq6311]

Troll