| Basics of the Stellate Ganglion Block
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Basics of the Stellate Ganglion Block

Basics of the Stellate Ganglion Block

Stellate Ganglion Block

The stellate ganglion  is part of the sympathetic nervous system located in the neck, on each side of the larynx. The stellate ganglion block is used to relieve head, neck, upper chest, and upper arm pain. This bock also increases circulation and blood flow to the arm region.

What conditions are treated using the stellate ganglion block?

A stellate ganglion block is used to treat:

  • Reflex sympathetic dystrophy
  • Complex regional pain syndrome
  • Phantom limb pain
  • Causalgia
  • Herpes zoster infection (shingles)

What is the purpose of the stellate ganglion block?

The stellate ganglion block is used to stop pain signal transmission from the sympathetic nerves that supply the arms to the brain. This also can reduce swelling and pain, as well as call color and sweating changes of the upper extremity. In addition, the stellate ganglion block is known to improve mobility.

How long does the stellate ganglion block take?

The total procedure takes 1-2 hours, which includes check-in, form signing, preparation, injection, and recovery. However, the actual injection only takes a few minutes.

How do I prepare for the stellate ganglion block procedure?

Before the procedure, you meet with the pain management doctor to discuss your condition. The doctor will assess your mental status, pain symptoms, medical condition, and physical health. When the doctor agrees that you need the stellate ganglion block, you are scheduled for the procedure. After the procedure is scheduled, the doctor reviews the risks and benefits and has you sign a consent form.

How is the stellate ganglion block performed?

After you are given an intravenous medication to relax, you lie on the procedure table. After the doctor cleans your neck using an antiseptic, the skin is numbed with a local anesthetic. Using ultrasound or x-ray guidance, the doctor inserts a second needle and positions it near the stellate ganglion nerve bundle. The medication injected is either/and/or an anesthetic (lidocaine, bupivacaine) or a neurolytic agent (phenol or absolute alcohol). After the needle is removed, a small bandage is applied.

How long does pain relief last?

Some patients feel immediate pain relief after the injection, but the pain returns after a few hours. However, long-term pain relief occurs after 2-3 days after a neurolytic agent is used, which offers long-term pain relief (up to 12 months). Sometimes, the block involves destroying the nerves using radiofrequency energy, which offers long-term pain relief. If you get pain relief after the first injection, the doctor may recommend another injection. The stellate ganglion block may be given in a series of three, spaced 1-4 weeks apart.

What can I expect after the stellate ganglion block procedure?

After the procedure, you will feel groggy from the sedation. A nurse monitors your condition as you awake. We recommend that you rest for 1-2 days, and gradually return to usual activities. In addition, you should avoid excessive and rigorous activities for a few days. Because a sedative was used, you should not drive for 24 hours.

Does the stellate ganglion block work?

According to a recent clinical study, the stellate ganglion block was used on 25 patients with a medical diagnosis of complex regional pain syndrome of the hand. All patients in the study had improved sympathetic function and decreased pain.

Resources

Ackerman WE & Zhang JM (2006). Efficacy of Stellate Ganglion Blockade for the Management of Type 1 Complex Regional Pain Syndrome. Southern Medical Association.

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