Stellate Ganglion Block

A sympathetic nerve block, such as the stellate ganglion block, is a procedure performed to determine if there is damage to the sympathetic nerve chain, which supplies the head, neck, chest, or arms, and to identify the source of pain in those areas. It may be used primarily for diagnostic purposes, but the stellate ganglion block might also provide pain relief beyond the duration of the anesthetic used.

Understanding the Sympathetic Nerve System

The sympathetic nerves, part of the autonomic nervous system, run along the front surface of the spinal column (not within the spinal canal where the central nervous system’s nerves are located). These nerves control essential involuntary functions. For instance, the autonomic system manages tasks that individuals do not consciously control, such as heartbeat and digestion. Sometimes, pain in the arm or leg may be caused by a malfunction of the autonomic system due to an injury. In such cases, blocking the sympathetic nerves may alleviate the pain.

What is a Sympathetic Nerve Block?

A sympathetic nerve block entails injecting medication around the sympathetic nerves in the lumbar (back) or cervical (neck) region. This temporary blockage aims to reduce or eliminate pain, with successive blocks applied until the pain lessens.

Pre-Procedure Guidelines

• Allergies: Notify staff of any allergies, especially to iodine.
• Eating Restrictions: Avoid eating on the morning of the procedure if sedation is planned.
• Diabetic Considerations: Insulin-dependent diabetics may need to adjust their insulin dose due to fasting.
• Regular Medications: Continue routine medications, including pain and anti-inflammatory medications.
• Blood Thinners: Inform staff if on blood thinners like Coumadin, as they may need to be stopped.
• Driving: It is usually recommended to have a driver to take you home.

During the Procedure

• IV and Positioning: An IV is started, and the patient is placed on their back for a neck block or their stomach for a lower back block.
• Preparation and Numbing: The skin is scrubbed, and a numbing agent is applied, which may sting briefly.
• Needle Placement: Guided by X-ray, a small needle is directed to the sympathetic nerves.
• Injection: After checking the needle position with dye, the local anesthetic is injected to block the sympathetic nerves.

After the Procedure

• Examination: The patient is examined immediately, and the percentage of pain relief is noted.
• Temporary Effects: Temporary numbness or weakness in the affected area may be felt.
• Potential Reactions: Any other potential reactions will be discussed at the time of the procedure.
• Resuming Activities: Normal activities may be resumed on the same day, though driving is discouraged.

The sympathetic nerve block is a specialized procedure that can offer diagnostic insights and therapeutic relief for certain types of pain, particularly those related to the autonomic nervous system. By directly targeting specific nerves with guided precision, it offers an approach that can be tailored to individual patient needs. Proper preparation and understanding of the procedure can enhance the experience and outcomes for those undergoing this minimally invasive intervention.