Use of stellate ganglion block to salvage an ischemic hand caused by the extravasation of vasopressors.

Abstract

This case report describes the successful use of early stellate ganglion block to salvage an acutely ischemic hand caused by the extravasation of vasopressors. 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. Stellate ganglion block may prove to be an early measure in the treatment of upper-extremity ischemia caused by vasopressor extravasation.