Clinical Outcomes of Cervical Stellate Ganglion Block in Patients with Secondary Lymphedema: A Pilot Study.

, Kim, Ho Geun; , Kim, Keewon; , Seo, Han Gil; , Im, Chae Young; , Kim, Tae Uk; , Chung, Sun Gun; , Noh, Dong Young; , Seo, Kwan Sik

Original Article

Journal of the Korean Academy of Rehabilitation Medicine 2009;33(3):297-303.

Kim, Ho Geun , Kim, Keewon , Seo, Han Gil , Im, Chae Young , Kim, Tae Uk , Chung, Sun Gun , Noh, Dong Young , Seo, Kwan Sik

¹Department of Rehabilitation Medicine, Seoul National University College of Medicine, Korea. kurmguro@paran.com
²Department of Neurology, Kangwon National University College of Medicine, Korea.
³Department of Surgery, Seoul National University of Medicine, Korea.

이차성 림프부종에 대한 경부 성상신경절 차단술의 임상적 효과: 예비조사

김호근, 김기원, 서한길, 임채영, 김태욱¹, 정선근, 노동영², 서관식

서울대학교 의과대학 재활의학교실, ¹강원대학교 의과대학 신경과학교실, ²서울대학교 의과대학 외과학교실

Abstract

Objective
To investigate the clinical effect of stellate ganglion block in patients with secondary lymphedema after breast cancer treatment.
Method
In a prospective clinical trial, the consecutive stellate ganglion block (SGB) was performed every two weeks to 10 patients (Mean age 46.0±9.4 (yr)) who was diagnosed as of secondary lymphedema after breast cancer treatment. The parameters were the circumstance of arm and the thickness of skin and subcutaneous tissue of the affected arm measured by ultrasonography. We measured these parameters with baseline value before SGB treatment and repeated the evaluation after each SGB treatment. And the subjective data of satisfaction, softness and improvement were obtained by questionnaires.
Results
10 patients were treated with stellate ganglion block. The mean circumferences of upper arm and forearm after three consecutive SGB treatments reduced significantly: upper arm from 31.39 cm to 29.72, forearm from 25.14 cm to 23.64 cm (p＜0.05). And the thickness of subcutaneous tissue of upper arm significantly decreased under no- compression measuring technique after three SGB treatments (p＜0.05). The compliance of superficial tissue showed significant change with serial procedure. Almost all of the patients had a satisfaction and feeling of softness in their affected arm after treatments.
Conclusion
The cervical stellate-ganglion block reduced the circumstance and the thickness of arm with lymphedema and satisfied almost lymphedema patients. So this treatment presents a favorable outcome to the breast cancer-related lymphedema patient clinically. (J Korean Acad Rehab Med 2009; 33: 297-303)

Key Words: Lymphedema, Stellate ganglion block, Postmastectomy