earticle

영어

Stellate ganglion block (SGB) may be of benefit for relieving symptoms of complex regional pain syndrome (CRPS), involving upper extremities. Typically, SGB induces vasodilation and hypotension due to sympathetic block. Hypertension after SGB has been documented in very few cases. We report a case of 16- year -old girl who developed hypertension after SGB. She was diagnosed with CRPS type I in her right arm 7 months ago, and was under outpatient observation. However, as the symptoms such as pain and edema relapsed, she was admitted to the pediatrics and referred to the pain clinic for interventional treatment. Her right pupil has been dilated for months after cimetropium bromide administration of pretreatment to gastrointestinal endoscopy, and she was taking a selective serotonin reuptake inhibitor. An ultrasoundguided SGB was performed using 5 mL of 2% lidocaine at C7 level. There were no acute complications after SGB. Two hours later, the patient exhibited acute hypertension, along with symptoms of chills and sweats. After taking a calcium channel blocker with acetaminophen administration, blood pressure normalized within hours. We postulate that diffusion of the local anesthetic along the carotid sheath may produce vagal block causing unopposed sympathetic activity as a result of attenuation of the baroreceptor reflex. Therefore, close hemodynamic monitoring is recommended in all cases of SGB.