The stellate ganglion block is a procedure that involves the injection of local anesthetics that are applied to the sympathetic nerves located in the neck on the sides of the voice box. This procedure is done with the specific intent of blocking the sympathetic nerves that branch out to the arms and to an extent, the nerves that extend to the face. This is in stark contrast to the Lumbar Sympathetic Block which blocks the sympathetic nerves that branch out to the leg, on the side where the injection is performed. But in similar fashion, the stellate ganglion block help reduce the pain and any swelling that may have taken place while simultaneously, improving mobility around the neck and facial region. This procedure is done to treat various other chronic conditions such as Complex Regional Pain Syndrome (CRPS), Reflex Sympathetic Dystrophy (RSD), and Sympathetic Maintained Pain.
This procedure usually takes a few minutes to perform and involves use of local anesthetics. On some occasions, other medications may be used in order to extend the duration of the stellate ganglion block such as a steroid medication, clonidine, or epinephrine. Patients can expect to experience some pain as the needle is inserted into the skin for the injection. Some anesthesia can be applied to help reduce the effects of the pain experienced, prior to the insertion of the needle for the actual block. Patients for the most part may need to undergo sedation via IV in order to better make the procedure more tolerable, as patients may fall asleep for a few minutes. As far the level of sedation is concerned, that all depends on the tolerance level of the patient.
For the procedure, the patient will be sitting in a slightly upwards manner with the chin raised up and turned sideways in order to proceed with the injection. Devices such as an EKG, blood pressure cuff, and oxygen-monitoring machines are utilized during the procedure to monitor the patient’s condition status. Before the actual injection takes place, the area around the voicebox is sterilized with antiseptic solution.
Patients are advised to arrange for transportation following the procedure. Patients are also advised to take it easy for perhaps a day or two following the procedure and to only engage in activities that they can physically tolerate. Patients may expect to feel some slight soreness around the area of the neck where the injection took place and can expect to return to work the next day unless complications from the procedure should arise.
Patients may be recommended for a further series of injections should they respond to the first one. Generally, patients may require 2-4 separate injections while others may need 10 or more. While the anesthesia will wear off after a hours, the actual blockage of the sympathetic nerves may last longer. The duration of the blockage gets longer following each procedure.