Advertisement

Facial Pain Treated with Stellate Ganglion Block

  • Jordan Taylor MacNeil
  • Johnathan H. Goree
Chapter

Abstract

The patient is a 51-year-old female who developed chronic facial pain following a radical neck dissection for T1N1 squamous cell carcinoma of the oral cavity, tongue, and right-sided cervical lymph nodes. She described her pain as a constant pulling sensation in the right side of her face. She also reported episodic sharp, shooting pain down her anterior and lateral neck with hyperalgesia of the surrounding skin. During her treatment course, she was unable to obtain control of pain with opioids, gabapentinoids, antidepressants (e.g., duloxetine), anxiolytics (e.g., alprazolam), or physical therapy.

Keywords

Stellate ganglion block Persistent facial pain Postsurgical neuropathic pain Refractory head and neck pain 

References

  1. 1.
    Chambers D, Huang C, Matthews G. Chapter 57: Pain physiology. In: Basic physiology for anaesthetists. 1st ed. Cambridge: Cambridge University Press; 2015. p. 269–74.CrossRefGoogle Scholar
  2. 2.
    Baron R. Mechanisms of disease: neuropathic pain—a clinical perspective. Nat Clin Pract Neurol. 2006;2(2):95–106.CrossRefPubMedGoogle Scholar
  3. 3.
    Perl E. Causalgia, pathological pain, and adrenergic receptors. Proc Natl Acad Sci. 1999;96(14):7664–7.CrossRefPubMedGoogle Scholar
  4. 4.
    Harden R, Oaklander A, Burton A, Perez R, Richardson K, Swan M, et al. Complex regional pain syndrome: practical diagnostic and treatment guidelines, 4th edition. Pain Med. 2013;14(2):180–229.CrossRefPubMedGoogle Scholar
  5. 5.
    Bruehl S. Complex regional pain syndrome. BMJ. 2015;351:h2730.CrossRefPubMedGoogle Scholar
  6. 6.
    Xie W, Chen S, Strong J, Li A, Lewkowich I, Zhang J. Localized sympathectomy reduces mechanical hypersensitivity by restoring normal immune homeostasis in rat models of inflammatory pain. J Neurosci. 2016;36(33):8712–25.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Kerry R, Taylor A, Mitchell J, McCarthy C, Brew J. Manual therapy and cervical arterial dysfunction, directions for the future: a clinical perspective. J Man Manip Ther. 2008;16(1):39–48.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Zakrzewska J. Differential diagnosis of facial pain and guidelines for management. Br J Anaesth. 2013;111(1):95–104.CrossRefPubMedGoogle Scholar
  9. 9.
    Rathmell J. Chapter 10: Stellate ganglion block. In: Atlas of image-guided intervention in regional anesthesia and pain medicine. 1st ed. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins Health; 2012. p. 151–61.Google Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of AnesthesiologyUniversity of Arkansas for Medical SciencesLittle RockUSA

Personalised recommendations