Alex Steen notched the deciding marker in the final round of the shootout, lifting St. Louis over Vancouver, 2-1, at Scottrade Center.
Andy McDonald opened the game's final session with a wrister, and Brian Elliott turned aside both Derek Roy and Alex Burrows in turn. Steen began the third round and ended the contest by whipping a wrister past Cory Schneider and under the crossbar.
Jay Bouwmeester posted the tying goal in regulation for the Blues, who had dropped two in a row but have taken seven of their last nine overall.
The narrow victory was the 600th in the career of head coach Ken Hitchcock, who is just finishing up his second season behind the bench in the Gateway City.
"It's basically because I'm old," Hitchcock said of the milestone. "If you last long and you're old, this is what you get."
Elliott ended up with 21 saves as St. Louis is battling to maintain position in the middle of the Western Conference playoff pack.
Alex Edler netted the lone score and Schneider made 35 stops for the Canucks, who have lost two of three but still sit atop the Northwest Division by a healthy margin over Minnesota.
Edler snapped a scoreless deadlock with 13 seconds left on the second-period clock when he ripped a shot off the post and in.
Bouwmeester evened the score thanks to a short-side bullet -- his first since being acquired from Calgary -- from the left wing off a 3-on-1 rush with 9:10 left in regulation.
"We had the second game of back-to-back and they came out at us hard," said Canucks captain Henrik Sedin about playing after a win at Nashville on Monday. "We fought back and had chances to win it."
St. Louis improved to 4-1 in the shootout this season, while Vancouver fell to 4-6 ... Edler's tally snapped the Blues' string of 23 consecutive penalties successfully killed entering Tuesday's game ... Prior to the contest, St. Louis revealed that forward T.J. Oshie had successful ankle surgery and is week-to-week while recovering ... Vancouver missed defenseman Kevin Bieksa with a lower-body injury ... Bouwmeester's tally snapped the Blues' scoreless string at 179 minutes, 24 seconds ... Hitchcock, who began his NHL coaching tenure with the Dallas Stars in January of 1996, improved to 67-31-13 as Blues head coach. He is the 11th man in league history to reach that number, following Scotty Bowman, Al Arbour, Dick Irvin, Pat Quinn, Mike Keenan, Joel Quenneville, Ron Wilson, Bryan Murray, Jacques Lemaire and Jacques Martin.