title: Treatment of patients with painful blind eye using stellate ganglion block.
abstract: OBJECTIVE
  management of pain in painful blind eyes is still a challenge. Corticosteroids and hypotensive agents, as well as evisceration and enucleation, are some of the strategies employed so far that are not always effective and, depending on the strategy, cause a deep emotional shock to the patient. Given these issues, the aim of this case report is to demonstrate a new and viable option for the management of such pain by treating the painful blind eye with the stellate ganglion block technique, a procedure that has never been described in the literature for this purpose.
  
  
  METHODS
  six patients with painful blind eye, all caused by glaucoma, were treated; in these patients, VAS (visual analogue scale for pain assessment, in which 0 is the absence of pain and 10 is the worst pain ever experienced) ranged from 7 to 10. We opted for weekly sessions of stellate ganglion block with 4 mL of bupivacaine (0.5%) without vasoconstrictor and clonidine 1 mcg/kg. Four patients had excellent results at VAS, ranging between 0 and 3, and two remained asymptomatic (VAS=0), without the need for additional medication. The other two used gabapentin 300 mg every 12h.
  
  
  CONCLUSIONS
  currently, there are several therapeutic options for the treatment of painful blind eye, among which stand out the retrobulbar blocks with chlorpromazine, alcohol and phenol. However, an effective strategy with low rate of serious complications, which is non-mutilating and improves the quality of life of the patient, is essential. Then, stellate ganglion block arises as a demonstrably viable and promising option to meet this demand.
authors.affiliation: Dr. Josefino Fagundes da Silva Pain Treatment Clinic, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.
authors.forename: Tatiana Vaz Horta
authors.initials: TV
authors.lastname: Xavier
authors.affiliation: Dr. Josefino Fagundes da Silva Pain Treatment Clinic, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil. Electronic address: thiagorobis@gmail.com.
authors.forename: Thiago Robis
authors.initials: TR
authors.lastname: de Oliveira
authors.affiliation: Dr. Josefino Fagundes da Silva Pain Treatment Clinic, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.
authors.forename: Tereza Cristina Bandeira Silva
authors.initials: TC
authors.lastname: Mendes
mesh_terms: D000588:Amines / Q000627:therapeutic use; D000700:Analgesics / Q000627:therapeutic use; D000779:Anesthetics, Local / Q000008:administration & dosage*; D001340:Autonomic Nerve Block / Q000379:methods*; D001766:Blindness / Q000209:etiology; D002045:Bupivacaine / Q000008:administration & dosage; D003509:Cyclohexanecarboxylic Acids / Q000627:therapeutic use; D058447:Eye Pain / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D000077206:Gabapentin; D005901:Glaucoma / Q000150:complications*; D006801:Humans; D010147:Pain Measurement; D011788:Quality of Life; D013233:Stellate Ganglion; D016896:Treatment Outcome; D005680:gamma-Aminobutyric Acid / Q000627:therapeutic use
chemical_list: D000588:Amines; D000700:Analgesics; D000779:Anesthetics, Local; D003509:Cyclohexanecarboxylic Acids; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin; D002045:Bupivacaine
keywords: Bloqueio nervoso; Dor ocular; Eye pain; Manejo da dor; Nerve block; Pain management