What is a Stellate Ganglion Block?
This type of block is a local anesthetic injection around the sympathetic nerve tissue (stellate ganglion) of the neck. These are the nerves that are a part of the sympathetic nervous system. These nerves can be found in the neck, on both side of the voice box.
What Is the Purpose of this Type of Block?
This type of block will numb the sympathetic nerves that go to the arms and to some degree, the sympathetic nerves that go to the face. This might in turn reduce swelling, pain, swelling color, and sweating changes in the upper extremity and might improve mobility.
This block is often done as a part of the treatment for Reflex Sympathetic Dystrophy (RSD), Herpes Zoster (shingles), Complex Regional Pain Syndrome, and Sympathetic Maintained pain, and involving the face, arm and the head.
Will the Block Hurt?
This block involves insertion of a needle through skin and deeper tissues. So, yes, there is some pain being involved. But, the deeper tissues or skin may be numbed with a local numbing medication using a very thin needle before injecting the actual needle with the block. Most of those individuals will also receive sedation intravenously which can help the entire process be more tolerable.
How a Stellate Ganglion Block done?
During the process of the block, pain-relieving medication is injected to the region where the ganglion lies. This might reduce the release of the chemical norepinephrine activating the pain sensitive nerves and reduces the pain. The patient is generally sedated, and using the guidance of an X-ray or fluoroscopy, a very fine needle is placed near the ganglion and anesthetic is injected.
The patient will not feel numbness in the face. He or she may develop a droopy eye, redness of the eye, feel warmth in the face and could experience voice hoarseness. These effects are only temporary and last a few hours. Relief of pain may also not be immediate. A pain diary is used following the procedure to track the response.
What is Actually Injected?
The injection consists of an anesthetic that is local. Steroid and epinephrine medication also might be added in order to prolong the effects of the block.
Will the Patient Be “Put out” for this Block?
Could be, or the block may be done under local anesthesia only. But, most of the patients also receive adequate sedation intravenous that they might go to sleep for several minutes during the actual injection. During the procedure patients breathe on their own. The amount of any sedation given normally is dependent on the patient’s tolerance but often can be enough that the patient will even have amnesia for the actual injection.
How is the Block Performed?
It is done with patient sitting up slightly. The chin is slightly raised and turned away from the side that is going to be injected. The patients are supervised with blood pressure cuff, EKG, and device that monitor the oxygen level the patient is receiving. Probes sensing the temperature are also placed on your hands. The skin in the front of the neck, close to the voice box is cleaned with antiseptic solution and then the injection is given.
What Should I do after Getting the Block?
You should arrange for a ride home. Patients need to take it easy for a day or so after the procedure. You many do the activities that you are reasonably able to tolerate. Some patients may go for immediate physical therapy.
Unless there are complications, you should be able to return to work the next day. You might feel some soreness in the neck at the injection site. The local anesthetic wears off several hours. But the actual blockade of the sympathetic nerves might last for many more hours. Usually, the duration of relief gets longer after each injection.
How Many Block do I need to have?
If you respond to the first injection, you will be recommended for repeat injections. Usually, a series of such injections is needed to treat the problem. Some may need only 2 to 4 and some may need more than 10. This response to such injections varies patient to patient.
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