A stellate ganglion block is used for both diagnostic and therapeutic purposes. Some common uses of a stellate ganglion block include improving vascular problems in upper extremities such as arterial insufficiency, Scleroderma, and Raynaud’s phenomenon. The procedure may also be performed to help with sleep dysfunction, hot flashes, post-traumatic stress disorder (PTSD), and hyperhidrosis.
One of the most common reasons a physician may order a stellate ganglion block is for the management of pain. Some of the pain syndromes which benefit from this procedure include:
- Phantom limb pain
- Herpetic neuralgia (herpes zoster/shingles)
- Shoulder or hand syndromes
- Reflex sympathetic dystrophy
- Intractable angina
- Nerve injuries (causalgia)
- Chronic arm or leg pain (complex regional pain syndrome)
- Sympathetically-maintained pain (SMP)
What is a stellate ganglion block?
In the sixth and seventh vertebrae of the neck are a collection of sympathetic nerves called the stellate ganglion. They are located in the front of the cervical vertebrae and form part of the nervous system leading to the face, neck, and upper extremities.
A stellate ganglion block is a procedure that provides anesthetic medication directly to these nerves. The stellate ganglion connects directly to the brain center known as the amygdala. By providing anesthesia directly to this collection of nerves, nerve impulses are reduced.
This procedure is sometimes also referred to as a cervicothoracic sympathetic block.
How does a stellate ganglion block help the patient?
A stellate ganglion block has numerous benefits, including reduction of sympathetic pain, edema and anxiety, and improved circulation, sleep function, and bodily temperature controls.
As a minimally invasive procedure that does not take long to administer, a stellate ganglion block provides treatment for a multitude of conditions. Patients experiencing pain often find relief instantly. And while the effects do wear off, fewer treatments are needed over time to provide relief.
As with any medical treatment, there is always the possibility of side effects. While the side effects for a stellate ganglion block are minimal and rare, patients should still be aware of these.
Potential side effects may include:
- Minor bleeding at the injection site
- Nerve injury
- Collapsed lung (pneumothorax)
- Esophageal perforation
- Allergic reaction to the medication
- Brachial plexus block (numbness in the limb)
- Spinal block (weakness or numbness from the neck down)
- Hoarse voice
- Shortness of breath
- Drooping eyelid
- Pupil constriction
- Decreased perspiration
Note that most side effects will subside once the anesthesia wears off. However, if a patient experiences difficulty breathing, sharp stabbing pain in either side of the chest, a dry cough, rapid heart rate, fatigue, fever or bluing of the skin, or sensitive redness at the injection site, they should contact their treating physician immediately.
A stellate ganglion block is an outpatient procedure and may be performed in one of three ways:
- Injection at the C6 cervical vertebra in the spine. This is located at the base of the neck and is the most common way of performing the procedure.
- Injection at the C7 cervical vertebra. This requires a smaller dose of the anesthesia and increases the risk of pneumothorax.
- Injection via the posterior paravertebral region. This procedure requires the additional use of fluoroscopy with contrast dye or ultrasound to reduce the potential for injury to soft tissue and vascular structures.
The decision of which procedure to use will depend largely on the needs of the patient. Each carries different risks and benefits, which will be discussed with you by your treating physician.
Regardless of the exact procedure performed, the patient will lie down on their back with the neck extended slightly. The head will be rotated to the side opposite the necessary block site and you will be asked to keep your mouth open.
Then, the site of the injection will be prepped before anesthesia is administered. Topical anesthesia will be applied to the skin and once ready, your physician will retract your sternocleidomastoid muscle and carotid artery. This will permit the palpation of the Chassignac’s tubercle to reduce the chance of pneumothorax. You may experience mild discomfort from this part of the procedure.
The needle may then be inserted and a local anesthetic administered. In some cases, a neurolytic agent such as phenol may be used.
In total, the procedure generally takes less than fifteen minutes to complete. In some cases, the physician may use intravenous sedation. Once complete, your pain and vital signs will be monitored and you will be placed in a sitting position to ensure maximum effectiveness of the anesthetic.
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Many people today suffer in silence but this need not be the case. If you are experiencing pain in your face, hands, or neck, a stellate ganglion block may help. The only way to know for sure is to consult with a physician. Why not schedule a consultation at any of our seven convenient locations now.