The stellate ganglion, which is located in front of the 7th cervical vertebra, is a network of neurons created by the union of the lower cervical and first thoracic ganglions.
Nerve damage to the neural network in the stellate ganglion can cause symptoms of pain and discomfort in the head, face, upper chest (shoulder blade), hands, and fingers. Conservative drug therapy using anti-inflammatory or opioid medications is frequently ineffective in such cases.
A stellate ganglion block involves injecting local anesthetic into the sympathetic nerves in the neck region. This specific procedure serves both diagnostic and therapeutic purposes. It is used to manage neuropathic pain in the head, neck, upper limbs, and upper chest. If a diagnostic block with local anesthetic is successful, radiofrequency neurolysis of the ganglion may follow.
The stellate ganglion block procedure is usually performed under local anesthesia, and is ultrasound-, fluoroscopy-, or CT scan-guided to confirm needle position. The entire procedure takes about 30 minutes.
There are two types of conditions that can be efficiently treated by inhibiting the stellate ganglion: pain conditions and arterial insufficiency.
• Severe headaches
• Cancer pain in the upper chest, head, neck, or arms
• Complex Regional Pain Syndrome (CRPS)
• Resistant angina
• Hyperhidrosis (excessive sweating)
• Phantom limb syndrome or discomfort
• Herpes zoster in the upper chest, head, neck, or arms
• Post-operative pain
• Radiation-induced neuritis
• Raynaud’s disease
• Arterial emboli
• Vasospasms
• Scleroderma
• Inadequate lymphatic drainage and post-mastectomy localized edema
Stellate ganglion block is not indicated in the following conditions and disorders:
• Infection
• Patient refusal
• Allergy to the anesthetic
• Hemophilia A and B
