Stellate Ganglion Nerve Blocks
Stellate Ganglion Blocks are indicated for painful syndromes of the upper extremities such as Complex Regional Pain Syndrome (CRPS) Type-I & II, refractory angina, phantom limb pain, and vascular insufficiency syndromes like scleroderma, frostbite, vasospasm and Raynaud’s Syndrome.
Administration of local anesthetics during this procedure can block the ganglion and correct a variety of disorders, particularly CRPS. The injection of the anesthetic is given at the base of the neck, using XRAY guidance. Since the patient is asked not to speak during the procedure, continual hand signals are used to maintain communication and assure patient comfort and safety.
A warm feeling and an increased temperature in the affected extremity indicates a successful block. Horner syndrome (eyelid drooping, redness of the eye, and papillary constriction) is a fairly conclusive indication of a successful stellate ganglion block, and occurs in almost 75% of cases. Other symptoms that may occur include hoarseness due to anesthetizing the laryngeal nerve, and numbness in the arm.
Pain relief is generally noted immediately. The duration is variable, and can increase with repeated procedures. The patient generally recovers from the procedure within one hour. Patients on blood thinners or who have problems with blood clotting, and patients who have glaucoma, a heart condition or symptomatic bradycardia should not undergo this procedure. The risk of complications with stellate ganglion block is very low, and is reported to be around 1.7/1000. Severe risks include seizure or inadvertent spinal or intravascular injection. Should a patient develop difficult breathing hours after the procedure, 9-1-1 should be called for an extremely rare possibility of a blood collection behind the throat. This complication is indeed rare, but has been documented in the literature. More commonly, there may be some bruising and pain at the site of injection, which usually resolves in a couple of days.