Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Nov 1998
Blood flow velocity changes in carotid and vertebral arteries with stellate ganglion block: measurement by magnetic resonance imaging using a direct bolus tracking method.
Stellate ganglion block (SGB) leads to vasodilation of the head and neck, as a result of a regional sympathetic blockade. However, in such cases, controversy remains concerning changes in cerebral and extracerebral blood flow in the head. We estimated the effect of SGB on blood flow in the head by measuring the blood flow velocity in cervical vessels, using magnetic resonance imaging and the direct bolus tracking method. This noninvasive method is free from potential artifacts of bones and other connective tissues. ⋯ Blood from the VA flows primarily to cerebral vessels, whereas that from CCA goes to both cerebral and extracerebral vessels. Given the presumed differences in blood flow distribution through the VA and CCA, we assume that the observed CCA blood flow increases, ipsilateral to the SGB, primarily as a result of vasodilation of extracerebral vessels and independent of changes in brain blood flow.
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Epidural catheters are seldom difficult to remove from patients. In fact, a review of the literature demonstrates only a few cases pertaining to epidurals and the unusual complication of catheter entrapment. ⋯ This case report involves an uncomplicated obstetric patient who had an epidural placed for labor and in whom multiple attempts were needed to remove the catheter.