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Stellate Ganglion Block

Stellate ganglion block is the injection of a local anesthetic that temporarily interrupts activity in the sympathetic nerves in the neck.

What are the stellate ganglion nerves?

They are a group of nerves located in the neck, next to, but not in, the spine.  This group of nerves is part of a larger system of nerves called the autonomic nervous system.  These nerves influence and help control the size of blood vessels and thus the flow of blood to the arms, head and neck.

Who may benefit from a stellate ganglion block?

Patients with pain in the upper extremities caused by reflex sympathetic dystrophy (RSD) or complex regional pain syndrome (CPRS).
Patients with a sympathetic ganglion disorder that causes deceased blood flow to arms, hands, fingers, or face.

How will a stellate ganglion block treat my condition?

Patients with RSD, CPRS, or a sympathetic ganglion disorder have decreased blood flow to the arms.  By temporarily interrupting activity in stellate nerves, the injection of local anesthetic improves blood flow to the arms.  If you have significant pain relief after the first stellate ganglion block, you may be scheduled for a series of these blocks to treat the condition.  The goals of these stellate ganglion blocks are to relieve pain and improve blood flow in the arms, hands, or face.

How do I prepare for this procedure?

You MUST have someone with you to drive home.

  • You may have clear liquids after midnight until 2 hours before your appointment and the nothing to eat or drink.  Clear liquids include Jell-O, broth, 7-Up, tea, coffee and apple juice.  No milk or milk products.  You may take all your normal medications, including pain medication with a sip of water.
  • If you are diabetic or have a bleeding disorder or take medications such as Coumadin, Lovenox, or Plavix that affect your bleeding, please call us at 570-271-6621.
  • Bring a list of your medications including dose and how often you take them.
  • Please bring with you any x-rays or MRI films and reports not done at Geisinger Medical Center.
  • You should plan on being here 2 to 4 hours.
  • Your exam and/or treatment will be done in the interventional Pain Center at Geisinger - Woodbine.

What happens during the procedure?

  • You will lie on your back with your head tilted back over a rolled blanket.
  • The area of your neck is cleaned with an antiseptic solution.
  • The doctor will check for landmarks in your neck to find the correct site for injection
  • The doctor will place the needle and inject local anesthetic for the block along the sympathetic nerves.

How long does it take?

The procedure takes 5-10 minutes.

What complications might occur?

  • Fever
  • Infection at injection site
  • Bleeding

What happens after the procedure?

You will be taken to our recovery area where your blood pressure and pulse will be monitored for 15-20 min.  You will be offered liquids.  Discharge instructions will be reviewed and you will receive a copy of them when your check out.

Side Effects

  • Droopy eyelid
  • Red or blood-shot eye
  • Stuffy nose
  • Feeling of a "lump" in your throat
  • Hoarseness
  • Tearing
  • Warmth or tingling in your arm or hand

Discharge instructions

  • No strenuous activity for 24 hours after the injection.
  • Do Not drive or operate machinery until the next day.
  • Take your usual pain medications or prescriptions as written.
  • You may eat your normal diet
  • You may have soreness or bruising at injection site
  • If you develop difficulty swallowing, do not eat solid food – take liquids only until this goes away.

Warnings: Call Pain Medicine, 570-271-6621

  • Fever greater then 101 degrees
  • Redness, swelling or pus-like drainage at injection site
  • Severe headache

Return your follow-up questionnaire in the envelope provided in 7-10 days.

Your return appointment will be scheduled when you check out.

If you have any problems or concerns, please call us at 570-271-6621 Monday through Friday 7:30 to 4:30.  If it is after hours, call 570-271-6211 and ask for the Chronic Pain physician on call.