Tonic-clonic seizure during the ultrasound-guided stellate ganglion block because of an injection into an unrecognized variant vertebral artery: A case report.
Medicine (Baltimore)
; 98(48): e18168, 2019 Nov.
Article
en En
| MEDLINE
| ID: mdl-31770265
ABSTRACT
RATIONALE Recent years have witnessed a marked improvement in the safety and accuracy of nerve blocks with the help of ultrasound and other visualization technologies. This study reports a challenging case of a severe complication during the ultrasound-guided stellate ganglion block. PATIENT CONCERNS A 28-year-old male patient with refractory migraine complained episodic pulsatile pain with photophobia, haphalgesia of the scalp for 3 years. INTERVENTIONS:
Ultrasound-guided stellate ganglion block with 4âml of 1% lidocaine was administrated.OUTCOMES:
A sudden loss of consciousness and tonic-clonic seizure was occurred after negative aspiration and test dose. Further sonographic examination revealed a variation in the left vertebral artery, which remained unrecognized during the needle insertion because of its sliding ability under the differential pressure applied by the probe. LESSONS Inadvertent intra-arterial injection of a local anesthetic agent could be minimized under the ultrasound guidance with various protective strategies, including the determination of any prior variation, optimizing the block route, maintaining a constant probe pressure, and using saline for the test dosage. This case resulted in the implementation of new protocols of the ultrasound-guided stellate ganglion block in our department.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Convulsiones
/
Bloqueo Nervioso Autónomo
/
Ganglio Estrellado
/
Inconsciencia
/
Arteria Vertebral
/
Complicaciones Intraoperatorias
/
Lidocaína
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
Límite:
Adult
/
Humans
/
Male
Idioma:
En
Revista:
Medicine (Baltimore)
Año:
2019
Tipo del documento:
Article
País de afiliación:
China