Stellate Ganglion Block

Stellate Ganglion Block is a medical procedure in which medication, in combination with an anesthetic, is injected into the sympathetic nerves located at the level of the neck.

What does a stellate ganglion block do?

The stellate ganglion block acts by blocking the sympathetic activity of the stellate ganglion, thus blocking the pain signals that are transmitted to the brain. Apart from the pain relief, the stellate ganglion block contributes to the reduction of inflammation, eliminating the color and sweating changes that are associated with different health problems in the area.

What is a stellate ganglion block used for?

These are the medical conditions for which the stellate ganglion block can be used:

• Reflex sympathetic dystrophy
• Sympathetic maintained pain
• Complex regional pain syndrome
• Herpes Zoster (shingles)
• Raynaud’s phenomenon
• Hyperhidrosis
• Reduction of symptoms experienced by women who have survived breast cancer (hot flashes, night awakenings)
• Improvement of the symptoms in women who are going through extreme menopause
• Nerve injuries
• Angina

It should be noted that the stellate ganglion block can also be used for diagnostic purposes, as the injection of the local anesthetic allows the doctor to identify the exact location of the pain (thus suggesting the potential causes).

Technique

The first step of the procedure is to disinfect the area of the injection. It should be noted that the stellate ganglion is located at the level of the seventh cervical vertebra, at a close distance from the subclavian artery and just above the first rib.The patient is lying down and it is commonly sedated. For the guarantee of the best results, the doctor will use the X-ray guidance (fluoroscopy), in order to reach the stellate ganglion with a fine needle and inject the anesthetic, together with the pain-relieving medication.The procedure may be done with local anesthesia but, in the majority of the cases, the general anesthesia is preferred. During the procedure, the vital signs of the patient are going to be strictly monitored. The injection is made next to the voice box and it can last for a couple of minutes before it is completed.

What does the medication consist of?

As it was already mentioned, in order to obtain the best results, the doctor will combine an anesthetic with pain-relieving medication, such as epinephrine or corticosteroids. The main purpose of this combination is to provide long-lasting relief from the pain and other symptoms experienced due to enhanced sympathetic activity.

How effective is stellate ganglion block?

The response to the stellate ganglion block varies from one patient to the other. In general, the stellate ganglion block is an effective procedure, providing relief from the pain that can last several months. However, it should be noted that the level of efficiency is reduced for patients who suffer from advanced cases of the above mentioned syndromes.

What to expect after stellate ganglion block?

Immediately after the procedure, you may experience a sensation of warmth that goes down your arm. Given the fact that the doctor has also inserted a local anesthetic, you might experience immediate relief from the pain (as soon as you wake up). After the procedure, you might also experience the side-effects that are caused by the injection, which you will find presented in detail, in the paragraphs below.As soon as you wake up from the procedure, provided there are no complications, you will be allowed to go home. You will need someone to pick you up and take you home. The doctor will advise you to avoid strenuous physical effort during the first few days after the procedure. You may also keep a pain diary, so as to notice the differences after the procedure. Physical therapy might also be recommended for a better recovery.

What are the risks of the procedure?

In general, the stellate ganglion block is a relatively safe procedure. However, one of the risks commonly associated with this procedure is the pain at the injection site. Do not worry, as this is only temporary and you will certainly notice it subsiding over the course of days. The other risks are related to infection, hemorrhage, nerve injury and anesthesia. These are however very rare risks and you should not worry about them.

Does the injection hurt?

As opposed to other types of procedures, the stellate ganglion block requires for the needle to enter through a vein and reach the site of the injection. This means that there will be some pain to be experience, despite the usage of local anesthetics. In order to eliminate the pain or discomfort associated with this procedure, the doctor will most likely use intravenous sedation. This will ensure that the patient tolerates the procedure in a far better manner.

Recovery

The recovery from the stellate ganglion block is quite rapid, especially if there are no complications resulting from the procedure. Given the fact that it is a minimally-invasive procedure, you should be able to go home. You can go to work the next day but you will need to avoid strenuous physical effort, especially if you want to recover faster. In general, you will feel like yourself again in a couple of weeks. Physical therapy might also speed up the recovery process, helping you with the other symptoms you might have experienced.

Side effects

Due to the injection of medication into the stellate ganglion block, you might experience certain side-effects, such as: pain sensation at the site of the injection (temporary), sensation of warmth going down the arm (territory covered by the stellate ganglion, temporary as well), lump-in-the-throat sensation, hoarse voice (the injections is made near the voice box), droopy and red eyes, nasal congestion (on the site of the injection) and headaches. It should be noted that all of these side-effects are only temporary and they will go away on their own, without any medical intervention or treatment being necessary.In conclusion, the stellate ganglion block is an extremely useful procedure for those who are suffering from painful syndromes. However, it remains of limited usage in those who have suffered from such problems for prolonged periods of time or have been diagnosed with severe forms.