Stellate Ganglion Block

What is a stellate ganglion?

The stellate ganglion is located in your neck next to your voice box. This is part of something called the sympathetic nervous system which a “highway” through which some pain fibres travel. Thus, an injection (block) at this area can help provide pain relief to the head, neck, arm and chest. In some cases, an injection done here can improve blood flow to the arm.

In which conditions is a stellate ganglion block performed?

It can be performed when there is pain in the head and neck, arm or upper chest due to:

  • Shingles/Herpes Zoster pain
  • Complex Regional Pain Syndrome type I or II
  • Phantom limb pain
  • Angina
  • Frost-bite/Vascular disease

How is a stellate ganglion block done?

First, you may be given an intravenous medication to relax you. Then, you’ll lie on your back on an x-ray table and your neck will be cleansed. A local anaesthetic will be given to numb the skin near the voice box. This will be followed by another needle that will be guided to the ganglion with X-ray or ultrasound guidance. The whole procedure should take around 30min after which you will be observed for about an hour before being discharged home.

Is a stellate ganglion block effective?

There may be immediate pain relief with the injection but this may wear off with the local anaesthetic within a few hours. A longer term pain relief may kick in after 2-3 days from the action of the steroid. How long this pain relief lasts will differ from person to person and on the disease. Some patients will need only a single block while another person will need 5 or more injections before adequate relief is achieved. The block is used as part of a multi-modal pain management effort so you will need to continue with medications, physiotherapy and other treatments until advised by the doctor to stop.

Is a stellate ganglion block risky?

The risk of the procedure is very low. Nevertheless, there may be infection, bleeding and nerve damage which is uncommon. There may also be temporary bruising, increased pain from needle injection as well as red, teary eyes, drooping eyelids, nasal congestion, voice changes, difficulty speaking and swallowing, coughing, tingling sensation down the hand and chest. These may persist for several hours.

What should I do after the procedure?

You should avoid any strenuous activities and driving for a day. You should also slowly test swallowing small amounts of food and sipping water once your voice returns to normal in order to avoid choking. There can be a return to normal activities the next day.