FAQs on Stellate Ganglion Block

To relieve the pain associated with the upper extremities, a stellate ganglion block is used. The stellate ganglion is a nerve bundle that helps transmit pain signals from the hands, arms, and shoulders to the brain.

What is the purpose of the stellate ganglion block?

The stellate ganglion block has three functions. These are:

  • Diagnostic – The block helps the pain specialist discover if the pain is related to the sympathetic nerves.
  • Prognostic – The block helps the doctor determine if a more detailed procedure will be effective, such as radiofrequency ablation, chemoneurolysis, or neurolysis.
  • Therapeutic – The block is used to alleviate pain and associated symptoms.

What medications are used during the block?

When done for diagnostic purposes, the pain specialist uses local anesthetics, such as lidocaine or bupivacaine. For therapeutic reasons, a neurolytic agent is often used, such as absolute alcohol or phenol. A sedative is used, such as Ativan or Versed. In addition, contrast dye, antiseptic solutions (betadine), and fluids are also used.

How long does the stellate ganglion block take to perform?

The procedure takes around 10-20 minutes to perform, but expect to be at the surgical center 60-90 minutes. This includes preparation time and recovery observation time.

What conditions are treated using the stellate ganglion block?

This block is used to treat:

  • Raynaud’s syndrome
  • Acute herpes zoster (shingles) pain
  • Phantom limb pain
  • Neuropathic pain
  • Vascular insufficiency
  • Complex regional pain syndrome (CRPS)
  • Cancer pain
  • Post-herpetic neuralgia
  • Atypical facial pain
  • Trigeminal neuralgia

What can I expect before the stellate ganglion block procedure?

It is important that you notify the physician of all your medications and all your medical conditions. Certain blood-thinning agents must be held for several days before the procedure. In addition, people with bleeding disorders may not have the block. Because sedation or anesthesia may be used, do not eat or drink six hours beforehand, and take necessary medications with small sips of water. When you arrive at the medical center, a nurse goes over the pros and cons of the stellate ganglion block and asks you to sign a consent form. After you change into a gown, a nurse places an IV catheter in your arm.

What happens during the procedure?

Monitoring devices will be attached to your body to assess heart rate, blood pressure, and oxygen levels. The skin of the neck is cleansed with an antiseptic solution, and the skin and deeper tissues are numbed using an anesthetic. Using x-ray guidance, a needle is inserted near the nerve bundle and medication is instilled onto the nerves. After removing the needle, a dry bandage is applied to the insertion site.

What can I expect after the stellate ganglion block?

After the procedure, a nurse will monitor your condition for several minutes. Expect the arm on the injected side to feel slightly numb, warm, and tingling. Side effects only last for a few hours, however, and include drooping of the eyelid, hoarseness, and watery eyes. We recommend you rest for the remainder of the day and only return to usual activities when you feel better.

How effective is the stellate ganglion block?

In a recent research study, researchers found that the stellate ganglion block is effective 76% of the time, and pain relief lasts for around 12-24 weeks. The results vary from patient-to-patient, with more than half of study participants reporting complete pain relief, and an additional third reporting some pain relief.

Resources

Ackerman, W.E. & Zhang, J.M. (2006). Efficacy of Stellate Ganglion Blockade for the Management of Type 1 Complex Regional Pain Syndrome. Southern Medical Journal, 99, (10).

Yucel I, Demiraran Y, Ozuran K, & Degrimenci E (2009). Complex regional pain syndrome type I: efficacy of stellate ganglion blockade. J Orthop Traumatol, 10(4): 179-183.