Stellate Ganglion Block

A ganglion is a group of nerves. One part of the sympathetic nervous system chain is the stellate ganglion that is located in the neck. It controls blood flow to the head and arms, and is sometimes involved in pain transmission from those areas. A SGB involves the injection of a local anesthetic (like Novocain) around the stellate ganglion. A SGB may be performed if your facial or arm pain is thought to be sympathetically mediated. A SGB is both diagnostic as well as therapeutic, meaning that in addition to determining the cause of your pain, the block may treat the pain problem as well. Sympathetic pain results from the inappropriate activation of sympathetic nerves. This can result from any type of injury, large or very small, such as a paper cut. For whatever reason, these nerves can be activated and result in a chronic pain syndrome. This syndrome is referred to either as Complex Regional Pain Syndrome (CRPS I or II) which are also know as RSD (reflex sympathetic dystrophy) and Causalgia. Often, the skin becomes very sensitive, frequently changes color and temperature, and is associated with severe spontaneous pain at times. If left untreated, it can become somewhat permanent. Medications may not be effective. The appropriate treatment involves temporarily blocking these sympathetic nerves with local anesthetics either once, or multiple times if needed. It is not known why temporarily blocking these nerves re-sets the nerves back into their normal state, thus treating the pain syndrome.

An IV will be placed before the procedure. You will lie with your head tilted back. Your neck will be cleansed with an antiseptic. The doctor, by using his sensation of touch and pressure, will guide the needle to the correct area and then inject the local anesthetic. The procedure will take about 20 minutes. Your blood pressure and pulse will be monitored after the procedure for 15 minutes. You may experience the development of a "bloodshot" eye, nasal stuffiness, hoarse voice, difficulty swallowing, and the sensation of warmth, or tingling in your hand. These symptoms should disappear in 6 to 12 hours. A nurse will review your discharge instructions before you go home.