What is the Stellate Ganglion Block?
Stellate Ganglion Block is an injection of local anaesthetic in the sympathetic nerve tissue. These are the nerves that are a part of the Sympathetic Nervous System and are located in the neck, on either side of the voice box. Stellate Ganglion Block is an injection of local anesthetic into the front of the neck that is typically ordered for pain located in the head, neck, chest or arm.
What is the purpose of a Stellate Ganglion Block?
The Stellate Ganglion Block is meant to block the Sympathetic Nerves. This may further lead to a reduction in pain, colour, swelling and sweating changes in the upper extremity and may also improve mobility. A Stellate Ganglion Block is administered as a part of the treatment for following conditions, including circulation problems and nerve injuries:
- Complex Regional Pain Syndrome (CRPS)
- Sympatheticalluy Maintained Pain
- Refractory Angina
- Shoulder/Hand syndrome
- Herpes Zoster (Shingles)
The pain relief experienced received from a Stellate Ganglion Block will affect one side of the head and netk, the upper arm and the upper part of the chest on the same side of the body.
Before the Procedure
Do not eat or drink for 6 hours; however take your medications as usual. However you can take drink water up to 2 hours prior to the procedure. Arrange for a ride home. as you cannot drive after the procedure.
What happens during the procedure?
- You will lie flat with a pillow under your shoulders to tilt your head back
- The doctor will cleanse your neck with an antiseptic solution and cover your face with sterile towels, exposing your neck for the injection
- You will be asked not to move, swallow or talk until the procedure is complete.
- An ultrasound machine would be used to guide the needle.
- It is fairly pain free procedure and except the freezing part, you will be in uncomfortable position, but painless.
- The necessary checks, such as pulse and blood pressure will be made before the patient is discharged.
- The procedure itself will last about 10 minutes.
What is expected after the procedure?
It is common to experience the following on the affected side for about 2 to 10 hours:
- Increased warmth to the hand
- Droopy upper eyelid
- Redness of the eye
- Pupil of the eye remains very small
- Hoarse voice
- Stuffy nose
- Difficulty swallowing
- Sometimes numbness over some areas of the hand or arm.
How long the effect of medication lost?
The local anaesthetic effect wears off in a few hours. However the blockade of sympathetic nerves may last for many hours. Usually the duration of relief gets longer after each injection
Will the stellate ganglion block help me?
Stellate ganglion injections can be but do not work for everyone. It is very difficult to predict if the injections will help you or not. Patients who present early in course of illness respond better. There are some risks associated with the procedure but it is worth trying. The benefits may be long or short term. The important thing is to continue and increase simple exercises. For example:
- Try and Increase your general activity a little each day.
- Use the affected limb as much as possible. After the injections it is important to do some active exercises in the affected limp while there is pain relief from the injections How many injections do I need to have ?
If you respond to the first injection, you will be recommended for repeat injections. Usually, a series of such injections is needed. Some may need only 2 to 4 and some may need more than 10. The response to such injections varies from patient to patient.
What are the risk factors involved?
The procedure of Stellate Ganglion Block has a few very rare but serious adverse effects including:
- Pneumothorax (collapsed lung)
- Brachial plexus block (numbness in the arm that lasts for long)
- Spinal or epidural block
- Nerve damage