Stellate Ganglion Block

Treatment Information

What is a stellate ganglion block?

A stellate ganglion block is the injection of a small amount of local anesthetic and steroid near a group of nerves in the neck area. The stellate ganglion is made up of the fused portion of the seventh cervical and first thoracic sympathetic ganglia.

 

What are reasons to do a stellate ganglion block?

A stellate ganglion block may be performed if you are experiencing facial pain, neck pain, or arm pain as a result of the following: shingles affecting the trigeminal nerve or cervical and upper thoracic dermatomes; acute vascular insufficiency of the face and arms; chronic regional pain syndrome (RSD) of the face, neck, arms, and upper thorax; Raynaud’s syndrome of the arms; phantom limb pain; and sympathetically mediated pain from cancer.

 

What are reasons NOT to do a stellate ganglion block?

A stellate ganglion block will NOT be performed if you have an active infection, fever, bleeding problems, allergy to the local anesthetic and steroid, and/or pregnancy.

 

What are the preparations for the procedure?

Before the procedure, you are asked NOT to eat for four (4) hours prior and NOT to drink liquids two (2) hours prior to your procedure time. You must have someone of age to drive you home following your procedure, as you will not be permitted to drive a vehicle on the day of your procedure. Anyone who is taking a blood thinning medication such as coumadin will be required to stop that medication for a specified time period before the procedure. Otherwise, you may take your regularly prescribed medications the morning of your procedure with a sip of water. If you are a diabetic patient, you may eat a limited amount before your procedure to avoid hypoglycemia. Patients that are on Coumadin must be off of that medication, with permission of prescribing physician, for 3-5 days. Patients that are on Plavix must be off of that medication, with permission of prescribing physician, for 7 days.

 

What are possible complications from the procedure?

This procedure does come with risks. Complications that can occur include but are not limited to local anesthetic toxicity, bruising, hematoma formation, injection of local anesthetic into the epidural, subdural, and subarachnoid spaces, total spinal anesthesia, pneumothorax, Horner’s syndrome causing drooping of the eyelid, block of the recurrent laryngeal nerve causing hoarseness and difficulty swallowing, infection, and reaction to the steroid medication.

 

What are possible side effects of the steroid medication?

Administration of steroid medication can cause side effects. Side effects can include but are not limited to hyperglycemia, altered menstrual cycle, fluid retention, bruising, insomnia, sweats, hot/cold flashes, flushing of the face, weight gain, epidural lipomatosis, steroid myopathy, avascular necrosis of bone, osteoporosis, and Cushing’s syndrome.

 

What will occur during the stellate ganglion block?

After learning about the procedure from physician or physician assistant an informed consent paper (giving permission for the procedure) must be signed by the patient. Then, the patient is taken to the procedure room by a staff member. You will then lie down on the x-ray table on your back. The area to be injected will be cleaned using an antiseptic solution, which is usually betadine unless you are allergic to this. Numbing medicine will then be injected under the skin to numb the area where the injection will occur. Under x-ray guidance, a needle will be localized. Once the needle is placed, a small amount of dye will be injected to confirm needle placement and to rule out vascular injection and once the dye shows normal spread, a small amount of local anesthetic with steroid will be injected. Prior to the procedure, skin temperature will be checked in the arm, and then it will be rechecked after the procedure to document any changes.

 

How long is the procedure?

Usually this procedure takes approximately 5-10 minutes to complete.

 

What happens after the procedure?

After the procedure is completed, the patient is taken to our recovery area. There, you will be monitored closely by checking the blood pressure, heart rate, pain score level, and any skin temperature changes in the affected arm. You may be given something to drink at this time. Also, the staff will be observing for any signs of side effects from the procedure. When ready, you will be given discharge instructions and any follow-up information that is needed.

 

Important Notes

  • After this procedure, you may experience any of the following that can last until the local anesthetic wears off completely: drooping of the eyelid, red or “blood shot” eyes, tearing, nasal stuffiness, hoarse voice, sensation of a “lump” in your throat, difficulty swallowing, and sensation of warmth or tingling in your hand. These symptoms will disappear as the medication wears off.
  • If you suspect you might be pregnant or know you are pregnant, please notify the physician or any staff member, as this is a reason NOT to do the stellate ganglion block.
  • If you are a diabetic patient taking insulin or pills to manage your diabetes, the steroid used in the stellate ganglion block can raise your blood sugar level temporarily. You should monitor your blood sugar level closely after your procedure. If your blood sugar level continues to be elevated then contact your primary care physician for suggestions on how to best manage this issue.
  • After the procedure, you should resume your regular medications as you are prescribed if those medications were stopped before the injection.

* If you do not understand any part of the above material, please discuss it with your physician or physician assistant. *

 

Related Information

Other Treatments

 

Related Documents

Discharge Instructions

Patient Pain Diary

 

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