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Gadhinglajkar S, Sreedhar R, Unnikrishnan M, et al. Electrical storm: Role of stellate ganglion blockade and anesthetic implications of left cardiac sympathetic denervation. Indian J Anaesth. 2013;57(4):397-400doi: 10.4103/0019-5049.118568.
Gadhinglajkar, S., Sreedhar, R., Unnikrishnan, M., & Namboodiri, N. (2013). Electrical storm: Role of stellate ganglion blockade and anesthetic implications of left cardiac sympathetic denervation. Indian journal of anaesthesia, 57(4), 397-400. https://doi.org/10.4103/0019-5049.118568
Gadhinglajkar, Shrinivas, et al. "Electrical storm: Role of stellate ganglion blockade and anesthetic implications of left cardiac sympathetic denervation." Indian journal of anaesthesia vol. 57,4 (2013): 397-400. doi: https://doi.org/10.4103/0019-5049.118568
Gadhinglajkar S, Sreedhar R, Unnikrishnan M, Namboodiri N. Electrical storm: Role of stellate ganglion blockade and anesthetic implications of left cardiac sympathetic denervation. Indian J Anaesth. 2013 Jul;57(4):397-400. doi: 10.4103/0019-5049.118568. PMID: 24163457; PMCID: PMC3800335.
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Indian J Anaesth. 2013 Jul;57(4):397-400. doi: 10.4103/0019-5049.118568.

Electrical storm: Role of stellate ganglion blockade and anesthetic implications of left cardiac sympathetic denervation.

Indian journal of anaesthesia

Shrinivas Gadhinglajkar, Rupa Sreedhar, M Unnikrishnan, Narayanan Namboodiri

Affiliations

  1. Department of Anesthesiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India.

PMID: 24163457 PMCID: PMC3800335 DOI: 10.4103/0019-5049.118568

Abstract

An electrical storm is usually associated with catecholaminergic surge following myocardial ischaemia and manifest as recurrent ventricular arrhythmias, requiring frequent DC shocks. Delivering repeated DC shocks induces myocardial damage and further worsens the arrhythmias, which are resistant to the antiarrhythmic drugs. Cardiac sympathetic blockade abates the excessive catecholaminergic drive and help pacifying the malignant ventricular arrhythmias. We treated the electrical storm in a 52-year-old male with ultrasound-guided left sympathetic ganglion block followed by surgical left cardiac sympathetic denervation. The patient remained symptom-free without any incident of ventricular arrhythmias for 8 months after the surgery. The ultrasonography during blockade of the stellate ganglion enhances the success rate of the technique, reduces the quantity of local anaesthetic required to produce desired effects and prevents technical complications. Supraclavicular surgical access to the upper thoracic sympathetic chain obviates the necessity for one lung ventilation and lateral decubitus during surgery, when the patient is in hemodynamically unstable condition. Sympathectomy can be performed under general anaesthesia taking cautions to avoid sympathetic stimulation in intraoperative period.

Keywords: Electrical storm; stellate ganglion block; sympathectomy

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