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Stellate Ganglion Block

The stellate nerve ganglion is found in the neck area on either side of the trachea. It controls blood flow and pain pain signals to the head, neck and face. A stellate ganglion block is used for treating pain and vascular instability associated with:

  • Reflex sympathetic dystrophy of the head
  • Causalgia
  • Herpes zoster (shingles)
  • Paget’s disease
  • Phantom limb pain
  • Vascular insufficiency, i.e. Raynaud’s disease
  • Scleroderma
  • Thrombosis
  • Shoulder-hand syndrome
  • Hyperhidrosis (excessive sweeting)

Benefits

A reduction in the amount of pain is often felt within 15-20 minutes but can be delayed. The patient will also feel an increase in temperature in the affected arm as the blood supply is increased. It is unusual for pain relief to be permanent after a single stellate ganglion block, but, with repeated blocks on alternate weeks, relief often is prolonged. A course of 5-8 injections is considered normal.

Preparation

Before the block:

  • Bring all your medications so we can list them on your chart.
  • Remove all jewelry especially around your neck.
  • Do not eat 6 hours prior to your appointment.
  • Be sure your bring someone to drive you home.

Possible Risks

Common:

  • Temporary hoarseness and a feeling of a lump in the throat.
  • Bruise at needle site.
  • Temporary drooping of the eyelid with redness of the inner eyelid.

Uncommon:

  • Pneumothorax or punctured lung.
  • CNS effects – hypotension, urticaria.
  • Bilateral block may result in airway problems.
  • Temporary loss of sensation in the arm (rarely affected).

Procedure

  • The nurse will:
  • Start an IV for conscious sedation.
  • Put a heart monitor on.
  • Put a blood pressure cuff on your arm.
  • Your heart and blood pressure will be monitored throughout the procedure.
  • You may receive medication through your IV to help you relax.
  • You will be positioned on your back with your head tilted back.
  • The doctor will touch your neck to locate anatomical landmarks.
  • The needle will be inserted and you will feel pressure as the medication is slowly injected. You may feel some shoulder pain as the medicine is injected.

After the Procedure

You may feel hoarse, feel a lump in your throat, and/or feel nasal congestion. Your face may feel warm and dry. The eye on the side the block was done will probably droop, feel moist, and your pupil may constrict. These are temporary conditions and should go away in a few hours. The most immediate evidence of a successful block is the patient’s report of a decrease in pain and pain symptoms. It is often best to avoid eating for at least 2 hours after the block until you are able to swallow without difficulty (and, thus, also to avoid choking).

Please notify your doctor if you experience any shortness of breath or chest pain after your block.

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