Impact of Neck Position on the Probability of Common Carotid Artery Puncture During Ultrasound‐Guided Stellate Ganglion Block. Issue 5 (28th March 2019)

• Record Type: Journal Article
• Authors: Park, Dong Yoon; Kang, Seok; Kang, Hyo Jung; Choi, Jun Kyu; Do Kim, Jae; Yoon, Joon Shik
• Is Part Of: PM&R. Volume 11:Issue 5(2019)
• Page Start: 463
• Page End: 469
• Publication Date: 2019-03-28
• Subjects: Medical rehabilitation -- Periodicals; Physical therapy -- Periodicals; Physical Therapy Modalities -- Periodicals; 615.5
• DOI: 10.1016/j.pmrj.2018.08.376
• Languages: English
• ISSNs: 1934-1482

Abstract

Abstract : Background: The carotid artery must be avoided during stellate ganglion block. However, information on optimal neck position during the ultrasound‐guided approach is limited. Objective: To investigate the relation between the target area of the procedure and the carotid artery in different neck positions. Design: Observational study. Setting: Tertiary university. Participants: A total of 30 sides of the neck from 18 healthy participants were included. Methods: An ultrasound transducer was placed at the level of the anterior tubercle of C6 with a short‐axis view for measuring the distance from the tip of the C6 anterior tubercle to the margin of the carotid artery. The participants were first examined through ultrasonography in 3 different rotational neck positions (neutral, semicontralateral rotation, and full‐contralateral rotation), in the supine position. After changing to the lateral decubitus position, the measurement was performed again in the same 3 neck positions. Main Outcome Measures: The C6 anterior tubercle to carotid distance was measured with ultrasound. Results: The C6 anterior tubercle to carotid distance was the longest with full‐contralateral neck rotation ( P < .05). The distance was longer in the semicontralateral neck rotation compared with the neutral neck position ( P < .05). Supine or decubitus positions did not affect the distance. Conclusions: We suggest that the full‐contralateral neck rotation posture in either the supine or decubitus position is most beneficial for avoiding damage to the carotid artery during the ultrasound‐guided stellate ganglion block. Level of Evidence: Not applicable.