Determination of Longus Colli Muscle Thickness by Ultrasonography

How Far Should The Needle Be Withdrawn for Stellate Ganglion Block: Determination of Longus Colli Muscle Thickness by Ultrasonography

This study aims to assess the longus colli muscle thickness by ultrasonography in order to guide stellate ganglion blocks

Study Overview

• Status: Completed
• Conditions: Hyperhidrosis; Complex Regional Pain Syndromes; Pain, Intractable; Pain Syndrome

Detailed Description

Stellate ganglion block is an interventional pain management procedure that is often performed for diagnostic and therapeutic purposes. It has long been performed with the guidance of fluoroscopy, and despite the increasing use of ultrasonography in recent years, fluoroscopy is still the gold standard method.

In traditional fluoroscopic method, the needle is directed to the transverse process of the C6 vertebra, after touching the anterior tubercle (Chassaignac's tubercule) the needle is slightly withdrawn and following a negative aspiration, injection is performed.

The ideal placement of the needle should be anterolateral to the longus colli muscle and deep to the prevertebral fascia. Further placement may cause intramuscular spread and superficial placement may cause injection in the carotid sheath or vascular structures. These are the most important reasons for clinical ineffectiveness. How far should the needle be withdrawn? Data is inconsistent in the literature.

The primary aim of this study is to determine the distance from transverse process to longus colli muscles anterior border and from transverse process to carotid sheath's posterior border. Secondary aim is to investigate the relationship between longus colli muscle thickness and age, gender, height, weight, BMI and neck circumference.

• Study Type: Observational
• Enrollment (Actual): 200

Contacts and Locations

Study Locations

• Turkey
  • Istanbul, Turkey, 34093
    • Halil Çetingök

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 65 years (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Healthy volunteers

Description

Inclusion Criteria:

• Age between 18 - 65 years,
• Giving informed consent for examination, ultrasonographic evaluation and study participation

Exclusion Criteria:

• Having a chronic neck pain for more than 6 months,
• Having any neurological or musculoskeletal conditions that may affect the anatomy of cervical region (cervical disc herniation, torticollis, severe scoliosis, vertebral malformation, spinal stenosis, myopathies, etc.)
• Having a history of surgery or radiation therapy in the cervical region

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Distance between corpus and longus colli muscle's anterior border on C6 level (millimeters)	Distance between corpus and longus colli muscle's anterior border on C6 level will be evaluated with ultrasonography.	0 minutes

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Distance between corpus and longus colli muscle's anterior border on C7 level (millimeters)	Distance between corpus and longus colli muscle's anterior border on C7 level will be evaluated with ultrasonography.	0 minutes
Maximum anteroposterior width of longus colli muscle on C6 level (millimeters)	Maximum anteroposterior width of longus colli muscle on C6 level will be evaluated with ultrasonography.	0 minutes
Maximum anteroposterior width of longus colli muscle on C7 level (millimeters)	Maximum anteroposterior width of longus colli muscle on C6 level will be evaluated with ultrasonography.	0 minutes
Distance between esophagus and estimated needle plane (millimeters)	Distance between esophagus and estimated needle plane will be evaluated with ultrasonography.	0 minutes
Neck circumference (centimeters)	Neck circumference	0 minutes

Collaborators and Investigators

• Sponsor: Istanbul University
• Investigators: Principal Investigator: Halil Çetingök, Ass. Prof., Istanbul University Istanbul Faculty of Medicine, Department of Pain Medicine

Publications and helpful links

General Publications

• Ates Y, Asik I, Ozgencil E, Acar HI, Yagmurlu B, Tekdemir I. Evaluation of the longus colli muscle in relation to stellate ganglion block. Reg Anesth Pain Med. 2009 May-Jun;34(3):219-23. doi: 10.1097/AAP.0b013e3181a32a02.
• Narouze S. Ultrasound-guided stellate ganglion block: safety and efficacy. Curr Pain Headache Rep. 2014 Jun;18(6):424. doi: 10.1007/s11916-014-0424-5.

Study record dates

Study Major Dates

• Study Start (Actual): March 1, 2021
• Primary Completion (Actual): March 1, 2022
• Study Completion (Actual): June 1, 2022

Study Registration Dates

• First Submitted: September 28, 2021
• First Submitted That Met QC Criteria: October 24, 2021
• First Posted (Actual): November 4, 2021

Study Record Updates

• Last Update Posted (Actual): October 3, 2022
• Last Update Submitted That Met QC Criteria: September 30, 2022
• Last Verified: September 1, 2022

More Information

Terms related to this study

• Keywords: Ultrasound; Stellate Ganglion; Longus Colli Muscle
• Additional Relevant MeSH Terms: Mental Disorders; Pathologic Processes; Nervous System Diseases; Sweat Gland Diseases; Skin Diseases; Pain; Neurologic Manifestations; Disease; Neuromuscular Diseases; Peripheral Nervous System Diseases; Autonomic Nervous System Diseases; Hyperhidrosis; Syndrome; Complex Regional Pain Syndromes; Reflex Sympathetic Dystrophy; Somatoform Disorders; Pain, Intractable
• Other Study ID Numbers: 2021/182

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No