BLOCKING OF THE MIDDLE CERVICAL AND STELLATE GANGLIONS WITH DESCENDING INFILTRATION ANESTHESIA: TECHNIC, ACCIDENTS AND THERAPEUTIC INDICATIONS

The progress made recently in the diagnosis and treatment of certain diseases dependent on, or influenced by, stellate ganglion innervation has led to the current practice of blocking this ganglion by the infiltration of procaine hydrochloride. Although therapeutic indications for this practice are numerous today, the procedure has not been sufficiently popularized among surgeons who are interested in the therapeutic results obtainable from acting on the sympathetic innervation. The principal reason for this lack of popularity is the technical difficulty of blocking the stellate ganglion without accident and in such a way as to be well tolerated by the patient, particularly when repeated blocking with an anesthetic is necessary. This difficulty has been recognized by all with experience in blocking the stellate ganglion with an anesthetic. The problem results from the deep location of this ganglion and from its close relations to important organs. Owing to the anatomic relations of