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An unusual complication of sinus arrest following right-sided stellate ganglion block: A case report

Saxena, Ashok K., Saxena, Neeraj ORCID:, Aggarwal, Bhavna and Sethi, Ashok K. 2004. An unusual complication of sinus arrest following right-sided stellate ganglion block: A case report. Pain Practice 4 (3) , pp. 245-248. 10.1111/j.1533-2500.2004.04309.x

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We present a case of a 29-year-old female patient who had presented to us for the management of her chronic right shoulder–hand pain and developed a sinus arrest following a right-sided stellate ganglion block (RSGB). This patient on receiving a diagnostic RSGB via the anterior paratracheal (C6) approach developed sinus arrest followed by apnea and unconsciousness. On institution of resuscitative measures involving tracheal intubation, positive pressure ventilation, cardiac massage, and intravenous atropine, spontaneous cardiac activity recovered in about 3 minutes. Other signs and symptoms resolved fully in a total of 10 minutes. She had persistent postural hypotension lasting for about 24 hours requiring bed rest and was discharged about 36 hours after the procedure, without any adverse sequelae. As the sinus node is supplied by the right-sided sympathetic chain, its blockade probably resulted in unopposed parasympathetic activity leading to asystole. Available evidence of the role of right stellate ganglion in regulation of cardiac electrophysiology and functioning is also discussed.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Subjects: R Medicine > R Medicine (General)
Uncontrolled Keywords: Keywords: stellate ganglion block;anterior paratracheal approach;sinus arrest; sinus node; right-sided sympathetic chain; cardiac electrophysiology; PP interval; QTc interval
Publisher: Wiley-Blackwell
ISSN: 1530-7085
Last Modified: 24 Oct 2022 11:22

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