Stellate Ganglion Blocks
A Stellate Ganglion Block is an injection of local anesthetic in the “sympathetic nerve tissue”, the nerves which are a part of Sympathetic Nervous System. The nerves are located on the either side of the voice box, in the neck.
What is the purpose?
The injection blocks the Sympathetic Nerves. This may in turn reduce pain, swelling, color, and sweating changes in the upper extremity and may improve mobility. It is done as a part of the treatment of Reflex Sympathetic Dystrophy (RSD), Sympathetic Maintained Pain, Complex Regional Pain Syndrome, and Herpes Zoster (shingles) involving upper extremity or head and face.
How long does the injection take?
The actual injection takes only a few minutes.
What is actually injected?
The injection consists of a local anesthetic (like lidocaine or bupivacaine) and cortisone.
Will the injection hurt?
The procedure involves inserting a needle through skin and deeper tissues (like a “tetanus shot”). So, there is some discomfort involved. However, we may numb the skin and deeper tissues with a local anesthetic using a very thin needle before inserting the actual block needle. Most of the patients also receive intravenous sedation and analgesia, which makes the procedure easy to tolerate.
Will I be “put out” for this procedure?
No. This procedure is done under local anesthesia. Most of the patients also receive intravenous sedation and analgesia, which makes the procedure easy to tolerate. The amount of sedation given generally depends upon the patient tolerance.
How is the injection performed?
It is done either with the patient laying flat. The chin is slightly raised. The patients are monitored with EKG, blood pressure cuff and blood oxygen-monitoring device. The skin in the front of the neck, next to the “voice box” is cleaned with antiseptic solution and then the injection is carried out.
What should I expect after the injection?
Immediately after the injection, you may feel your upper extremity getting warm. In addition, you may notice that your pain may be gone or quite less. You may also notice “a lump in the throat” as well as hoarse voice, droopy and red eye, and some nasal congestion on the side of the injection. You may also develop a headache.
What should I do after the procedure?
You should have a ride home. We advise the patients to take it easy for a day or so after the procedure. Perform the activities as tolerated by you. Some of the patients may go for immediate physical therapy.