FAQs on Stellate Ganglion Block

Stellate ganglion block injections are extremely effective in the management of pain in the upper extremities. An advanced medical procedure, the pain treatment is considered among the most precise and accurate sympathetic block. rsd21

The therapy is best suited to treat neck, face, chest, and arms pain traced to neuropathic problem. Studies have also recognized the effectiveness of stellate ganglion block injections in reducing perspiration, curbing hot flashes, and enhancing blood circulation.

What is Stellate Ganglion Block?

Stellate ganglion block injections administer anesthetic medications into the sympathetic nerves in the neck to inhibit their ability to transmit the pain sensation. The stellate ganglion is an encapsulated neural hub of nerves located in the front neck on the seventh cervical vertebrae and just above the first rib on either side of the trachea.

Patients feel pain, swelling, and annoying symptoms following an injury impacting head, neck, upper chest or arms, as the sympathetic nervous system goes on overdrive and fails to maintain its normal functions. The stellate ganglion block procedure injects numbing medications to the nerves in the structure that lessens the swelling of the neural cells, increases blood circulation, and relieves pain in upper extremities.

When Patients Require Stellate Ganglion Block? What Conditions Are Treated Through Stellate Ganglion Block?

Stellate ganglion block is effective in treating medical conditions, including the following painful disorders affecting the upper extremities.

  • Complex regional pain syndrome or reflex sympathetic dystrophy is a multifactorial disorder caused by “aberrant response to tissue injury” and followed by neurogenic inflammation. It is discernible with “swelling, tenderness, burning sensation, and pain” in upper extremities.
  • The shoulder-hand syndrome that results in blood flow problems enhancing the stellate-ganglion-block-e1328696655805swelling and pain in neuron cells and causing flushing and discoloration in upper extremities.
  • Pain due to injury to nerves connecting hand, arm, neck, or chest
  • Pain due to vascular constrictions that shrink blood flow to hands, heart and other upper body parts.
  • Herpes Zoster pain, a type of acute spasmodic pain caused by formation of shingles or skin blisters around the nerves in the neck due to viral infection.
  • Pain due to posttraumatic stress disorder
  • Raynaud’s phenomenon or discoloration of extremities due to reduced blood flow
  • Scleroderma caused by deposition of fibrous connective tissues that hardens skin and leads to swelling, joint pain, and muscle weakness in and around face, arms, and hands.
  • Angina, vascular, and arterial insufficiency in upper body extremities
  • Phantom limb pain due to perception of pain where a limb is no more part of your body.
  • Hyperhidrosis or overactive sweat glands in the face and upper extremities resulting in increasing sweating
  • Hot Flashes and consequent sleep problem
  • Sympathetically-maintained pain syndromes felt in upper body parts

How Is Stellate Ganglion Block Performed?

The patient is asked to lie down on a bed and is administered intravenous sedation keeping in view the intricate anatomic structures at the bottom of the neck. Once the skin and tissues around the stellate ganglion are numbed up, doctors inject a needle to the structure under real time x-ray guidance obtained through fluoroscopy machine. Dye is put in to make sure that the needle is at the precise position targeted. Thereafter, the medication is administered through the needle.

What Is Injected During Stellate Ganglion Block?

Stellate ganglion block injections contain lidocaine or bupivacaine or any other local anesthetic. Many pain management specialists add epinephrine, a type of hormone, or phenol, a neurolytic agent, to protract the therapeutic effectiveness of the procedure. A radiofrequency ablation is also carried out in many cases to ensure that the sympathetic block prolongs.

How Long Does It Take?

It takes about 30 minutes to perform one stellate ganglion block procedure.

Do I Need Rest After Stellate Ganglion Block?

Stellate ganglion block is an outpatient procedure and patients go home as soon as it is over. It is always good to take rest for a day and avoid activities that can stress you or go beyond your level of tolerance. Patients can go for physical therapy, but it is not essential. They can join their work unless they suffer from any side effect.

How Many Stellate Ganglion Block Injections Should I Have?

The efficacy of the treatment varies from patient to patient. The effect of one stellate ganglion block procedure lasts for many hours providing relief to a patient for days. Usually, 2 to 4 injections are sufficient to minimize moderate pain. However, those with more serious conditions require 8 to 10 injections over a period of time.

What Are The Side Effects of Stellate Ganglion Block?

Injection-site soreness is the most common side effect of stellate ganglion block procedure. It is exceptional to develop any major adverse reaction. Patients may feel warm in their arm or lump in the throat, or nasal congestion at maximum. The voice may become hoarse for a few hours.

There are instances when patients develop momentary Horner’s Syndrome and experience flagging eye lid and pupil. Patients may suffer from the risk of nerve injury, allergic reaction, esophageal damage, or bleeding when the stellate ganglion block is not performed according to the standard procedure and by expert doctors.

How Well Does Stellate Ganglion Block Work? What Are The Benefits of Stellate Ganglion Block?

  • Stellate ganglion block is an effective way to treat pain in upper extremities, claims a 2008 meta-analysis. (Pain Practice, 2008)
  • Complex regional pain syndrome pain is significantly reduced with procedure. According to the Anesthesiology Clinics journal, stellate ganglion block are among the best possible treatment for reflex sympathetic dystrophy. (Anesthesiology Clinics, 2003)
  • The procedure is also beneficial in treating pain and blood flow.
  • Stellate ganglion block mitigates disorders, such as hot flashes, refractory angina, posttraumatic stress disorder, and shoulder-hand syndrome. (Lancet, 2008)

Why Should I Go For a Stellate Ganglion Block?

Stellate ganglion block injections are minimally invasive and extremely beneficial in inhibiting sympathetic pain syndromes. It is safe, without major complications, and less time consuming with significantly higher rate of successful pain management.

References

  • Cleveland Clinic
  • Pain Medicine, University of California
  • Day M; Sympathetic blocks: The evidence; Pain Pract. 2008; 8:98-109.
  • Meier PM et al; Lumbar sympathetic blockade in children with complex regional pain syndromes: A double blind placebo-controlled crossover trial; Anesthesiology. 2009; 111:372-380.
  • Stanton-Hicks M; Complex regional pain syndrome; Anesthesiol Clin North Am. 2003; 21:733-744
  • Klyscz et al; Improvement of acral circulation in a patient with systemic sclerosis with stellate blocks; Vasa. 1998; 27:39-42.
  • Lipov et al; Lancet Oncol. 2008
  • Ackerman and Zhang; Efficacy of Stellate Ganglion Blockade for the Management of Type 1 Complex Regional Pain Syndrome; Southern Medical Journal, 2006, Vol 99, Num 10