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ESRA19-0625 Case series of left stellate ganglion blocks for refractory angina pectoris: 14 year later and still efficacious
  1. Z Tan1,
  2. J Nalpon2 and
  3. K Valchanov3
  1. 1Singapore General Hospital, Department of Anaesthesia and Intensive Care, Singapore, Singapore
  2. 2Royal Papworth Hospital, Department of Nursing, Cambridge, UK
  3. 3Royal Papworth Hospital, Department of Anaesthesia and Intensive Care, Cambridge, UK


Background and aims Refractory angina pectoris (RAP) is a chronic pain condition characterized by chest pain secondary to diffuse coronay artery disease that is not amenable to medical or surgical intervention. Left cervical sympathectomy via left stellate ganglion block (LSGB) for refractory angina pectoris has been shown to improve pain control when all other analgesic options are exhausted.

Methods We present a case series demonstrating how a scientific trial has triggered a useful and minimally invasive treatment for RAP providing better analgesia for patients who suffer from this debilitating pain condition.

Results A total of 120 LSGBs were performed in our institution between 2011 and May 2019.The duration of analgesic benefit varied between 8 and 13 weeks. Towards the end of the analgesic effects, the angina symptoms become more frequent and more severe (intensity of pain and duration of angina attacks). Complication rate was low and limited to failure to produce analgesic benefit on 4 occasions (on which the block had to be repeated within 2 weeks) and 2 neck haematomas.

Conclusions We report excellent and safe analgesic benefit for patients with refractory angina pectoris using intermittent left stellate ganglion blockade with local anaesthetic. Our case series describes this treatment in an outpatient setting, which has minimal interference with patient’s life style.

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