星状神经节阻滞治疗面部顽固性疼痛1例

1 Case abstract Patient, male,68 years old,got obstinate facial pain 10 years ago after nerve block due to trigeminal neuralgia.Pain resulted in following dysfunction:facial asymmetry,atrophic left facial muscle was 1/2 size of right;Myodynamy decreased,only soft and semiliquid food could be taken and compensation of right muscle was needed;Pselaphesia and thalposis were lost and there was on feeling to water at 40 ℃ .Continuous facial pain led to unstable mood,diet decreasing,bad sleepness,light weight,bad facial impressions and mental disturbance at the end.Once took sedative analgesic drugs such as valium,but effect was unobvious.Diagnosis: left facial pain.According to case history,symptoms,block of left ganglion stellatum was adopted.Dorsal position,head hypsokinesis to expose neck, operator pushed common carotid artery towards external side, and inserted needle at cricoid cartilage level,between trachea and common carotid artery towards C7 transverse process,withdrew needle when feeling substance of bone, if no blood and brain fluid returned, injected 5 ml of 2% lidocaine.After withdrawing,Horner's syndrome and facial burning sensation at the same side often appeared,but complications from celostomea,numb of upper limb to dyspnea weren't found.One time every two days, 5 times as a therapeutic course,the interval was 2 weeks,and 3 therapeutic courses in total.Therapeutic effect was expressed by version analogue scale(VAS):Drew a thick line and divided it into 10 parts,0 indicated no pain,10 indicate severe pain.Patient drew at corresponding position to express his pain degree.Before treatment,VAS score was 7,after 1 therapeutic course decreased to 4,after 2 therapeutic courses,2～ 3,after 3 therapeutic courses it was 0～ 1.With the improvement of disease,atrophy of left facial muscle was also improved and closed to the size of right.pselaphesia and thalposis recovered,masticatory function improved,sleeplessness disappeared,other complications improved much.

Block therapy of ganglion stellatum in 1 case of obstinate facial pain

1 Case abstract Patient, male,68 years old,got obstinate facial pain 10 years ago after nerve block due to trigeminal neuralgia.Pain resulted in following dysfunction:facial asymmetry,atrophic left facial muscle was 1/2 size of right;Myodynamy decreased,only soft and semiliquid food could be taken and compensation of right muscle was needed;Pselaphesia and thalposis were lost and there was on feeling to water at 40 ℃ .Continuous facial pain led to unstable mood,diet decreasing,bad sleepness,light weight,bad facial impressions and mental disturbance at the end.Once took sedative analgesic drugs such as valium,but effect was unobvious.Diagnosis: left facial pain.According to case history,symptoms,block of left ganglion stellatum was adopted.Dorsal position,head hypsokinesis to expose neck, operator pushed common carotid artery towards external side, and inserted needle at cricoid cartilage level,between trachea and common carotid artery towards C7 transverse process,withdrew needle when feeling substance of bone, if no blood and brain fluid returned, injected 5 ml of 2% lidocaine.After withdrawing,Horner's syndrome and facial burning sensation at the same side often appeared,but complications from celostomea,numb of upper limb to dyspnea weren't found.One time every two days, 5 times as a therapeutic course,the interval was 2 weeks,and 3 therapeutic courses in total.Therapeutic effect was expressed by version analogue scale(VAS):Drew a thick line and divided it into 10 parts,0 indicated no pain,10 indicate severe pain.Patient drew at corresponding position to express his pain degree.Before treatment,VAS score was 7,after 1 therapeutic course decreased to 4,after 2 therapeutic courses,2～ 3,after 3 therapeutic courses it was 0～ 1.With the improvement of disease,atrophy of left facial muscle was also improved and closed to the size of right.pselaphesia and thalposis recovered,masticatory function improved,sleeplessness disappeared,other complications improved much.