Safety and utility of ultrasound-guided superior cervical ganglion block for headaches and orofacial pain: a retrospective, single-center study of 10 patients

Aiko Maeda, Yoji Chikama, Ryudo Tanaka, Masachika Tominaga, Kazuhiro Shirozu, Ken Yamaura, Aiko Maeda, Yoji Chikama, Ryudo Tanaka, Masachika Tominaga, Kazuhiro Shirozu, Ken Yamaura

Abstract

Background: Several new ultrasound-guided superior cervical ganglia blocks (U-SCGBs) have been proposed to overcome the shortcomings of conventional superior cervical ganglia blocks; however, their clinical utility and practicality have not yet been demonstrated. The aim of this study was to evaluate the safety and utility of a new method of U-SCGB.

Methods: We retrospectively collected data on patients who underwent U-SCGB for the treatment of headaches and orofacial pain at a single center. U-SCGB was performed by injecting 2-3 mL of 1% mepivacaine posterior to the internal carotid artery, just above the bifurcation. The Wilcoxon signed-rank test was used to compare pain scores. Numerical data are expressed as the mean ± standard error.

Results: The total number of U-SCGB procedures was 43. All procedures were accompanied by Horner's sign. The numerical rating scale score for pain (possible scores, 0-10) was reduced predominantly from 7.0 ± 0.7 before treatment to 4.5 ± 0.7 at the follow-up (p = 0.014).

Conclusion: U-SCGB was considered a clinically useful and accurate treatment for headaches and orofacial pain in this study.

Keywords: Headache; Orofacial pain; Stellate ganglion blocks; Superior cervical ganglion block; Ultrasound guidance.

Conflict of interest statement

The authors declare that they have no competing interests.

© 2023. The Author(s).

Figures

Fig. 1
Fig. 1
A represented ultrasound image of the left common carotid bifurcation (A) and axial section of T2 weighted magnetic resonance image at approximately the same level (B). A A needle (white arrow) is visualized from the right side of the image toward the LCM. The hypoechoic image in the LCM is due to local anesthetic injection. B The black dashed line indicates the expected route of needle insertion. ICA, internal carotid artery; ECA, external carotid artery; IJV, internal jugular vein (white arrowheads); LCM, longus capitis muscle; SCM, sternocleidomastoid muscle

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