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Stellate Ganglion Block

What is a stellate ganglion?

The stellate ganglion itself is a collection of nerves (sympathetic) found at the lowest two levels of the cervical section of vertebrae in the neck. The nerves are located in front of the vertebrae and are part of the sympathetic nervous system that supplies the face and arms. These nerves are not involved with feeling or movement. Sometimes, after a nerve gets irritated by trauma, infection or other causes, the sympathetic activity can cause pain.

What is a stellate ganglion block?

A stellate ganglion block (sympathetic block) is an injection of local anesthetic (numbing medicine) into the front of the neck. The sympathetic activity is blocked by numbing the stellate ganglion which can stop the pain. This type of block can also:

  • Diagnose the cause of pain in the face and head, arms and chest
  • Manage pain in the head, neck, chest or arms caused by nerve injuries, the effects of an attack of shingles or angina that doesn't go away
  • Provide pain relief on one side of the head and neck, the upper arm and the upper part of the chest on the same side of the body. A stellate ganglion block may be performed to decrease pain and increase the circulation and blood supply to the affected arm
  • Reduce sweating in the face, head, arms and hands
  • Treat reflex sympathetic dystrophy, sympathetic maintained pain or complex regional pain syndrome

Learn more about this exam:

  • We will contact you prior to your appointment to review medications you are currently taking, your medical history, potential risks and answer any of your questions.
  • Contact your provider before you stop taking any medication.
  • If you have films, reports or CD-ROMs of any MRI, CT or X-rays you have already had, please bring them to the appointment.
  • You will need a driver to bring you home after your appointment.
  • At your appointment, women should always inform their provider or X-ray technologist if there is any possibility that they are pregnant or if they are breast feeding.
  • Overall you should plan on approximately two and a half hours of your time for this procedure from check-in until you leave the clinic.
  • This procedure is performed in an Ambulatory Surgery Center (ASC), where you have access to I.V. sedation and monitoring by a nurse.
  • You will lie on your back with your head tilted slightly back and supported by a pillow.
  • The radiologist will apply a local skin anesthetic (numbing medication) near the base of the neck on the affected side.
  • Using X-ray guidance, our specialized radiologist will insert a thin needle and inject contrast solution. The contrast solution is designed to highlight your anatomy to make sure the nerve thought to be causing your pain is precisely targeted.
  • The radiologist will then slowly release a combination of anti-inflammatory (steroid) and anesthetic (numbing) medications into the stellate ganglion.

You may be asked to wait at the clinic for up to several hours for evaluation and observation.

  • You should have a ride home arranged and be prepared to take it easy for the next day or so. You should be able to resume normal activities the next day with some mild soreness in the neck.
  • You may note an increased warmth and redness of the painful arm during and after the injection.
  • You may be asked to keep track of how long pain relief lasts, especially during the first four hours after the block and report it to your provider; this information is useful to them when considering next steps.
    • If there is no change in the pain, then your provider can focus on other possible sources.
    • If the injection blocked your pain effectively, but only for a short time, your provider may request additional injections or consider a procedure that offers more permanent relief.

Although complications are rare, we will review possible side effects and risks with you prior to your exam so you can ask questions and decide if this exam is right for you.

 

NOTE: This procedure is not performed in all of our centers. Please contact the location or region nearest you for more information or to schedule an appointment. We are happy to help answer any questions you may have!