Stellate Ganglion Block

Stellate Ganglion Block

What is Stellate Ganglion Block?

Stellate Ganglion Block is an injection of local anesthetic in the sympathetic nerve tissue, the nerves that are located on the either side of the voice box, in the neck.

Effects of Stellate Ganglion Block

The injection blocks the sympathetic nerves, which may reduce pain, swelling, color, and sweating changes in the upper extremity and may also improve mobility.

Candidates for Stellate Ganglion Block

This procedure is done as a part of the treatment of Reflex Sympathetic Dystrophy, Sympathetic Maintained Pain, Complex Regional Pain Syndrome, and Herpes Zoster (shingles), involving upper extremity or head and face.

Your Consultation

First, the doctor will evaluate the patient and explain the procedure in detail, including possible complications and side effects. The doctor will also answer any questions that the patient may have and the patient should also inform the doctor of his current medications so he could be advised to continue taking the medications or not. The patient will also be required to fast for 6 hours before the procedure.

The Stellate Ganglion Block Procedure

The injection consists of a local anesthetic and epinephrine may be added to prolong the effects of the injection. The actual injection takes only a few minutes and it is done either with the patient laying flat or slightly sitting up, with the chin slightly raised. The patient will be monitored with EKG, blood pressure cuff and blood oxygen-monitoring devices. Temperature sensing probes will also be placed on the thumbs or hands. The skin in the front of the neck, next to the voice box will be cleansed with antiseptic solution and then the injection is carried out.

Recovery

You may feel your upper extremity getting warm immediately after the injection. You may also notice that your pain may be gone or quite less. You may also become aware of "a lump in the throat" as well as hoarse voice, droopy and red eye, and some nasal congestion on the side of the injection. It is possible that you may develop a headache.

It is recommended that you should take it easy for a day or so after the procedure. Some of the patients may go for immediate physical therapy. You should be able to return to your work the next day unless there are complications. The most common thing you may feel is just some soreness in the neck at the injection.

Risks

The most common side effect is temporary pain. Other risks involved are bleeding, infection, spinal block, epidural block, and injection into blood vessels and surrounding organs. Fortunately, serious side effects and complications are uncommon in this procedure.

FAQs

What is the purpose of Stellate Ganglion Block?

This procedure is performed to determine if there is damage to the sympathetic nerve chain and if it is the source of the patient’s arm pain. This is mainly a diagnostic block but may also provide pain relief in excess of the duration of the anesthetic.

Will the injection hurt?

The procedure involves inserting a needle through skin and deeper tissues (like a "tetanus shot") so expect some discomfort. But it is possible to numb the skin and deeper tissues with a local anesthetic using a very thin needle before inserting the actual block needle. Most of the patients also receive IV sedation and analgesia, which makes the procedure easier to tolerate.

How many injections do I need?

You will be recommended for repeat injections if you respond to the first injection. A series of such injections is usually required to treat the problem. Some may need only 2 to 4 and others may need more that 10. The response to such injections varies from patient to patient.

Will the Stellate Ganglion Injection help me?

It is very hard to tell if the injection(s) will indeed help you or not. The patients who present early during their illness tend to respond better compared to those who have this treatment after about six months showing symptoms. But patients in the advanced stages of disease may not respond adequately.

How long will the effect of the medication last?

Expect the local anesthetic to wear off in a few hours but the blockade of sympathetic nerves may last for many more hours. The duration of relief usually gets longer after each injection.

What are the expected results of this procedure?

The patient may notice an increased warmth and redness of the painful arm during and after the injection. Also, expect some hoarseness in the voice, redness of the eye, drooping of the eyelid and pupillary constriction for 4 to 8 hours after the injection. But pain relief may be noted immediately. The duration of relief may vary. The patient should assess the pain relief over the first 3 to 4 hours after the injection and report this to the anesthesiologist.