title: Trial ultrasound-guided continuous left stellate ganglion blockade before surgical gangliolysis in a patient with a left ventricular assist device and intractable ventricular tachycardia: a pain control application to a complex hemodynamic condition.
abstract: Stellate ganglion blockade for cardiac dysrhythmia is a well-described technique but infrequently used to manage ventricular tachycardia (VT). In patients with left ventricular assist devices (LVADs), these dysrhythmias cause increased morbidity because of right ventricular dysfunction, and often severe discomfort. Continuous stellate ganglion blockade may yield valuable information on a diagnostic and therapeutic basis in preparation for definitive, permanent interventions. We describe the successful management of intractable VT with continuous left stellate ganglion blockade, followed by surgical gangliolysis in a patient with an LVAD.
authors.affiliation: From the *Department of Anesthesiology, †Division of Thoracic and Foregut Surgery, and ‡Division of Cardiac Surgery, University of Rochester School of Medicine and Dentistry, Rochester, New York.
authors.forename: Daryl I
authors.initials: DI
authors.lastname: Smith
authors.forename: Carolyn
authors.initials: C
authors.lastname: Jones
authors.forename: Garret K
authors.initials: GK
authors.lastname: Morris
authors.forename: Sarah
authors.initials: S
authors.lastname: Kralovic
authors.forename: H Todd
authors.initials: HT
authors.lastname: Massey
authors.forename: Andrew
authors.initials: A
authors.lastname: Sifain
mesh_terms: D000368:Aged; D017147:Defibrillators, Implantable; D004562:Electrocardiography; D015171:Ganglionectomy / Q000379:methods*; D006353:Heart-Assist Devices; D006439:Hemodynamics; D006801:Humans; D008297:Male; D059408:Pain Management / Q000379:methods*; D013233:Stellate Ganglion / Q000000981:diagnostic imaging* / Q000601:surgery*; D017180:Tachycardia, Ventricular / Q000503:physiopathology* / Q000601:surgery / Q000628:therapy*; D014463:Ultrasonography; D018497:Ventricular Dysfunction, Right / Q000628:therapy