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Stellate Ganglion Block

 

Introduction

A stellate ganglion block is where local anaesthetic is injected into the sympathetic nerves on one side of the neck adjacent to the larynx (the 'voice box'). The stellate ganglion is a star-shaped grouping of nerves and nerve tissue next to the C7 vertebra. It is also sometimes referred to as the 'cervicothoracic ganglion'.

Sympathetic nerves are nerves that control 'autonomous' functions of the body, that is functions that are not controlled consciously, such as heart rate, sweating and blood flow.

Sympathetic nerves in this section of the neck transmit pain signals (and control other functions such as swelling and sweating) from the neck and head, and so may be implicated in conditions such as neuropathic pain syndromes.

A stellate ganglion block temporarily disables pain signals from this region of the body.

This type of block can be therapeutic, that is to directly treat the pain. When this block is used to treat pain, a number of treatments may be necessary over a period of several weeks.

A stellate ganglion block can also be used to treat circulatory problems of the upper limb.

Indications

  • Pain in the head, face, neck, chest or arm.
  • Neuropathic pain syndromes.

Preoperative Instructions

You should avoid undergoing any other medical procedures, such as for example dental treatment or a colonoscopy, within 48 hours (before or after) of a stellate ganglion block. You should also not have anything to eat or drink prior to the procedure.

Please also let us know ahead of the procedure if…

  • You are taking any antibiotics.
  • You have a pacemaker or defibrillator.
  • You have any allergies.
  • You are diabetic.
  • You are ill (in which case we may need to postpone the procedure).

You should not drive yourself to or from the appointment, or drive in the 24-hour period immediately after the procedure.

Procedure

You are asked to lie on your back on a treatment table, with a pillow placed under the shoulder blades. In some cases you may be asked to sit up a little. An IV line is put in place in your arm or hand (for anaesthesia or sedation).

Once the injection site is sterilised, a thin needle is inserted into the side of the neck to inject local anaesthetic to the area.

When the procedure is complete, you will need to spend around an hour under observation before being able to go home.

Postoperative Instructions

After the procedure it is normal to experience some drooping of the eyelid on the same side of your face as the injection. This may be accompanied by a hoarse voice or a blocked nose. All of these symptoms clear up within a few hours. You will generally be able to return to normal activities the day after the procedure. You will be asked to complete a 24-hour pain diary.

Someone from the clinic will call you within 1-2 days of the procedure to organise a follow up appointment.

Risks

A stellate ganglion block procedure is a relatively low-risk procedure – however all medical treatment comes with some level of risk. Possible complications may include…

  • Bleeding.
  • Infection.
  • Pain at injection site.
  • Lung puncture.
  • Puncture of a major blood vessel to the brain.
  • Puncture of the oesophagus.
  • Allergic reaction to anaesthetic.