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Delayed Severe Airway Obstruction Due to Hematoma Following Stellate Ganglion Block
  1. Mutsuo Mishio, M.D.,
  2. Tsutomu Matsumoto, M.D.,
  3. Yasuhisa Okuda, M.D. and
  4. Toshimitsu Kitajima, M.D.
  1. From the Department of Anesthesiology, Dokkyo University School of Medicine, Tochigi, Japan.
  1. Reprint requests: Mutsuo Mishio, M.D., Department of Anesthesiology, Dokkyo University School of Medicine, Mibu, Tochigi 321-0293, Japan.


Background and Objectives Delayed onset of airway obstruction following stellate ganglion block (SGB) may be life threatening. We treated a patient who developed a severe airway obstruction caused by a large hematoma several hours after an SGB.

Methods A 62-year-old woman suffering from sudden deafness developed dyspnea 2 hours after undergoing her fourth SGB, and evidenced swelling and tenderness in her anterior neck and chest. Her pharyngolaryngeal tissues were edematous, and the glottis was markedly narrowed. Computed tomograms and magnetic resonance images revealed a large soft tissue mass extending from the first cervical vertebra to the diaphragm.

Results Surgical tracheotomy was performed to maintain her airway. Swelling of the vocal cord disappeared on the eleventh day after the operation.

Conclusions We believe that the SGB needle injured the vertebral artery and caused massive hemorrhage anterior to the cervical vertebra, subsequently inducing pharyngolaryngeal edema by obstructing the venous and lymphatic drainage of the cervical region.

  • stellate ganglion block
  • airway obstruction
  • hematoma
  • computed tomography
  • magnetic resonance image

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