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Topics relating to Pain Prevention, Treating Pain & Pain Management

Sympathetic Nerve Block

Sympathetic Nerve Block

Stellate Ganglion block or Sympathetic Nerve Block

What is the Stellate Ganglion?

The Stellate Ganglion is a bundle of nerve fibers located in the lower neck. It is part of the sympathetic nervous system.

What is the sympathetic nervous system?

The sympathetic nervous system is responsible for the body’s response to situations during times of stress or danger. For example, sympathetic nerves cause the heart to beat faster and adrenaline to be released in preparation for our response to a stressful situation.  In addition, sympathetic nerve impulses cause the constriction of peripheral blood vessels (the arteries and veins in our arms and legs). The sympathetic nervous system is important for our physical protection.

treatment for CRPS, RSD nerve blockHow are sympathetic nerves involved with pain?

Sometimes a sympathetic nerve may be unnecessarily stimulated as a result of injury or other trauma to the body. In this situation, the involved sympathetic nerve will cause the blood vessels in the arm or leg to constrict and remain constricted resulting in poor circulation to that limb. The person may then experience pain and possibly swelling in the extremity, nail changes, unusual color of the skin, and temperature changes in the extremity. If the sympathetic nerve impulse is blocked, the blood vessels dilate, circulation is improved and pain relief may occur.

What conditions are treated with sympathetic nerve blocks?

The most commonly treated condition is Reflex Sympathetic Dystrophy (RSD) also known as Complex Regional Pain Syndrome (CRPS). These blocks may also be used in conditions in which increased circulation to a limb would be beneficial for healing as in diabetic neuropathy, Raynaud’s Syndrome, Berger’s Disease or slow healing wounds.  Sympathetic blocks may also be helpful in the diagnosis of certain conditions.

What can I expect during a Stellate Ganglion block?

Prior to a Stellate Ganglion block an IV is started so that you may be given IV sedation (if you opt for this). You will be given supplemental oxygen through a nasal cannula. You will be connected to a monitor to observe your blood pressure, heart rate and rhythm and oxygen level.  Skin thermometers will be placed on your hands. The physician and nurse will observe the thermometers for an increase in temperature in the hand on the side that was injected. A rise in temperature indicates that the Stellate Ganglion block was successful.  For the procedure you will be placed on your back with your neck extended. You will be asked not to speak or swallow during the procedure. The physician will feel your neck to locate the area that he will inject. The physician will cleanse the skin with an antibacterial solution. The skin will be numbed with a local anesthetic and then the physician will inject the medication into the stellate.

The specialist pain physician typically injects a combination of local anesthetic and steroid.

Are there risks with a stellate ganglion block?

As with any procedure, there is risk associated. The risks with stellate ganglion blocks though rare, are bruising swelling or inflammation at the injections site; infection, bleeding; transient numbness or drooping of the face; hoarseness; difficulty swallowing; breathing difficulty; or collapse of the lung.

What can I expect immediately after the stellate ganglion block?

The nurse will continue to monitor you for approximately one hour after the injection. This will include your blood pressure, heart rate, oxygen level and the temperature in your hands.

After a stellate ganglion block the temperature in your hand should increase. You may likely experience “Horner’s Syndrome” on the injected side. This is an expected side effect and indicates a successful block. Signs of Horner’s Syndrome include drooping of the face on the side that was injected, constriction of the pupil, redness and watering of the eye, flushing of the face, nasal congestion and hoarseness. These temporary side effects may last a few hours. The most important result is that the pain should decrease.

Newbridge SPine & Pain Center has locations in Maryland and Virginia. Our team of seasoned physicians are board certified Anesthesiologists with extensive experience and a reputation for excellence in pain management.