Persistent ptosis following stellate ganglion block with local anesthetic : A case report

Kim, Seung Yong; Kim, Young Hoon; Yang, Suk Woo; Moon, Dong Eon

Case Report

General Article

Anesthesia and Pain Medicine 2009;4(1):87-90.
Published online January 30, 2009.

Persistent ptosis following stellate ganglion block with local anesthetic : A case report

Seung Yong Kim, Young Hoon Kim, Suk Woo Yang, Dong Eon Moon

¹Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea. demoon@catholic.ac.kr
²Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Abstract

A 45-year-old woman underwent stellate ganglion block (SGB) for treatment of anosmia. She was treated with standardized SGB two to three times a week for two months. Although her anosmia improved slightly, she complained of discomfort and persistent ptosis in her left eye after the fourteenth block. After a five-month observation period, she was evaluated in the department of ophthalmology for persistent ptosis. A phenylephrine test suggested a neurogenic origin for the ptosis. Surgical repair was performed. Clinicians should be careful when performing SGB with local anesthetics to avoid microtrauma, ischemic injury, and neurotoxic injury of the sympathetic nerve fibers.

Key Words: anosmia, complication, Horner's syndrome, phenylephrine, ptosis, stellate ganglion