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Use of Stellate Ganglion Block to Salvage an Ischemic Hand Caused by the Extravasation of Vasopressors
  1. De Q.H. Tran, M.D. and
  2. Roderick J. Finlayson, M.D.
  1. From the Department of Anesthesia, Montreal General Hospital Site, McGill University Health Center, Montreal, Quebec, Canada.
  1. Reprint requests: Roderick J. Finlayson, M.D., Department of Anesthesia, Montreal General Hospital, 1650 Cedar Avenue, Montreal, Quebec, Canada, H3G 1A4. E-mail: rfinlay{at}


Objective This case report describes the successful use of early stellate ganglion block to salvage an acutely ischemic hand caused by the extravasation of vasopressors.

Case Report A young man with a gunshot wound to the right inguinal area was brought to the operating room for surgical hemostasis and exploration. After discovery that the central line had been inserted in the proximity of the area of injury (right femoral vein), the vasopressor infusions were changed to a 14-gauge intravenous line inserted in the dorsum of the right hand. When the intravenous line became infiltrated, the hand was found to be swollen, cold, and underperfused. A right stellate ganglion block was immediately performed to overcome the intense peripheral vasoconstriction and, thus, re-establish circulation to the hand.

Conclusions Stellate ganglion block may prove to be an early measure in the treatment of upper-extremity ischemia caused by vasopressor extravasation.

  • Ischemia
  • Nerve block
  • Stellate block
  • Vasopressors
  • Complications

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