Stellate Ganglion Block

Overview

The Stellate Ganglion Block is a procedure that involves the injection of local anesthetics applied to the sympathetic nerves located in the neck on the sides of the voice box. This procedure aims to block the sympathetic nerves that branch out to the arms and, to an extent, the nerves that extend to the face. Unlike the Lumbar Sympathetic Block, which targets the sympathetic nerves branching out to the leg, the stellate ganglion block helps reduce pain and swelling while improving mobility in the neck and facial region. It is used to treat various chronic conditions such as Complex Regional Pain Syndrome (CRPS), Reflex Sympathetic Dystrophy (RSD), and Sympathetic Maintained Pain.

Procedure

This procedure usually takes a few minutes to perform.  It involves the use of local anesthetics to numb the area. In some cases, additional medications such as steroids, clonidine, or epinephrine may be used to prolong the effects of the block. Patients may experience some discomfort as the needle is inserted into the skin for the injection. To minimize this discomfort, a local anesthetic can be applied before the needle insertion.

In some cases, patients may require intravenous (IV) sedation to make the procedure more comfortable. This sedation can vary in intensity depending on the patient’s tolerance level. It’s not uncommon for patients to briefly fall asleep during the procedure. Overall, the goal of sedation is to ensure that the patient remains comfortable throughout the process.

During a Stellate Ganglion Block procedure, the patient is typically seated upright with their chin raised and turned slightly to the side to facilitate the injection. Various monitoring devices, such as an EKG, blood pressure cuff, and oxygen-monitoring machines, are used throughout the procedure to ensure the patient’s safety and monitor their condition. Before the injection, the area around the voicebox is sterilized with an antiseptic solution to reduce the risk of infection.

After a Stellate Ganglion Block Procedure, patients are advised to arrange for transportation home, as they may experience some temporary numbness or weakness in the arm on the side of the injection. It is recommended to take it easy for a day or two after the procedure and to engage only in activities that they can physically tolerate. Some patients may experience slight soreness around the injection site in the neck. Typically, patients can return to work the next day unless complications arise.

Patients who respond well to the initial stellate ganglion block may be recommended for a series of injections. The number of injections needed can vary; some patients may require 2-4 injections, while others may need 10 or more. After the injection, the effects of the local anesthetic will wear off within a few hours. However, the actual blockage of the sympathetic nerves may last longer. With each subsequent procedure, the duration of the blockage may increase, potentially providing longer-lasting relief.