What is stellate ganglion injection?
A stellate ganglion block is a type of injection that stops nerve signaling from nerves in the neck at the sides of the voice box. This collection of cervical nerves—the stellate ganglion—are responsible for delivering many sensations (including pain signals and movement messages) to the brain. When these nerves are injured or otherwise compromised, a stellate ganglion block can help relieve pain, swelling, sweating, poor circulation, and poor mobility in the upper extremities.
How is the injection performed?
The patient lies on his/her back and the skin on the neck is cleansed with an antiseptic solution. The skin and deeper tissues are numbed by the physician with an anesthetic using a small needle and once the skin is numb, an X-ray machine or ultrasound helps guide the needle into the correct space. Once the space is entered, X-ray contrast is injected to ensure correct positioning of the needle, then medication consisting of a numbing medicine and a steroid (dexamethasone or triamcinolone) will be injected. The procedure takes approximately 5-10 minutes.
Will the injection hurt?
There is some discomfort with needle insertion which we minimize by numbing the skin with a local anesthetic. You may elect to have a small amount of sedating medication to help with discomfort and to help you relax.
How long does the effect last?
Stellate ganglion blocks can also be used diagnostically. If you experience pain relief, reduced swelling, and increased circulation and mobility, it confirms that the stellate ganglion is involved in your pain. This can help lead to a diagnosis of the underlying condition leading to pain
What is the next step after the injection?
It is very important for you to log your pain and activity for the several hours following your injection and report it to the Medical Assistant that calls you the following day. This will help us to measure your response to the injection and determine the next most appropriate plan of care. Some patients experience immediate, near-total relief from their pain and other symptoms with a stellate ganglion block. Others find at least partial relief in the days and weeks that follow. If the block is successful, many doctors find that a series of blocks offers the most relief.
What are the risks and side effects?
The risks of stellate ganglion block side effects and complications are low, but it’s important to understand the potential for them. Directly after the block, some patients may experience symptoms known as Horner’s syndrome. This includes drooping of the upper eyelid, pupil constriction, and decreased sweating. This is a normal response and expected. Symptoms usually subside when the anesthetic wears of (usually within four to six hours after the procedure).
Additional rare side effects and risks include: red eyes, feeling like you have a “lump” in the throat, difficulty swallowing, misplacement of the needle resulting in bleeding, nerve injury, collapsed lung (pneumothorax), esophageal puncture, hoarseness, shortness of breath, allergic reaction, numbness in the arm on the side of the block and/or weakness and/or numbness from neck down as long as the life of the injected anesthetic. Many of these side effects are short-lived and minor. If you have an active infection, fever, cold, or very high blood pressure, your doctor will not perform a stellate ganglion block until these conditions improve. Talk to your doctor if you are on blood thinners, as this may hinder your ability to receive this block.
