Stellate Ganglion Block
A stellate ganglion block may be used as part of a plan of treatment to relieve pain coming from your head, neck or arm. It may also be used to increase the amount of blood that flows to areas in the upper part of your body. The block involves an injection into the collection of nerves in the lower end of your neck. It may be used to relieve pain from:
- Complex Regional Pain Syndrome (of the upper limb and/or face)
- Raynaudʼs syndrome · Other upper limb pain that is thought to be influenced by certain types of nerves
- Chest pain not due to heart disease
Risks of this treatment
There may be a little bruising over the site the needle was inserted into. You may get a dry mouth, a hoarse or weak sounding voice, a runny nose and a slight droop in your eyelid. You may also get a feeling of being a little short of breath and have a warm feeling on your face. You may notice the pupil of one of your eyes is smaller than the other.
These are all results of the local anaesthetic spreading to the nerves. They are only temporary effects, lasting 4-6 hours at most. There is a chance that one of the blood vessels in the neck will be punctured during the injection, which will lead to bleeding and bruising.
There is also a chance that the local anaesthetic will affect the nerves in your arm causing a temporary weakness or heavy feeling. There is a small change that you may experience a fit. There is a very small chance that your lung could be punctured during the injection.
As with any injection, there is a very slight chance of getting an infection where the needle is placed. Every effort is made to avoid this with use of skin-cleaning solution, sterile gloves and equipment.
The procedure is made as safe as possible by being performed by an experienced pain doctor who constantly monitors you throughout the procedure. You may discuss the risks further with your pain doctor
Pre-operative assessment & Care
If you become pregnant, have any major illnesses/hospital admissions or start taking anticoagulant drugs (for example warfarin or clopidogrel) discuss this with the pain doctor before the procedure.
If you have diabetes, you may need to make some changes to your diabetes medicine or diet on the day of the procedure. You should discuss this with your pain doctor before your procedure.
On the day of the procedure:
· Follow the instructions given to you by the Day Surgical Unit staff about when last to eat or drink.
- Take all your usual medication including your painkillers
- Bring all your usual medication, or a list of what you are taking with you.
- Make sure that someone will collect you, take you home, and is available to stay with you overnight.
During the procedure At the Day Surgical Unit your pain doctor will see you and explain the procedure fully. Before the procedure starts a small cannula (tube) will be placed in a vein in the back of your hand through which we can give you medicines and fluids if that becomes necessary.
You will be given medication (sedation) to make you feel sleepy during the injection. An oxygen mask will be placed over your face. A needle is then placed in the skin to the side of your ʻAdamʼs appleʼ. This may sting initially, but the area will soon become numb. When you are numb, the needle will be guided into the group of nerves called the stellate ganglion.
The procedure takes about 15 minutes. After the procedure your blood pressure, pulse and respiration rate may be checked.
During the procedure
At the Day Surgical Unit your pain doctor will see you, and explain the procedure fully. Before the procedure starts a small cannula (tube) may be placed in a vein in the back of your hand through which we may give you medicines and fluids if that becomes necessary.
You may be given medication (sedation) to make you feel sleepy during the injection. An oxygen mask may be placed over your face. A needle is then placed to perform the facet joint injection.
A mixture of slow-release steroid and local anaesthetic, or just local anaesthetic, is injected. This procedure takes about 15-20 minutes. After the procedure, you may have your blood pressure, pulse and respiration rate checked.
After the procedure – what to expect
For some people, the stellate ganglion block may not reduce their pain at all. It may make the pain worse. You may feel weak or tired for a little while after the injection so we advise that you rest for 24 hours.
During this time you should not: drive a car or operate equipment, sign any legal documents or drink alcohol.
You should continue taking your usual medication and the next day you may take a bath, or shower, and remove any plasters. Please contact your GP (family doctor) if you have any other symptoms causing you concern and if:
- There is unusual redness or swelling at the injection site
- Your temperature is 38° C (100.4 F) or greater
After discharge home
To get the best out of your stellate ganglion block you should:
- Continue with your usual medication including your painkillers
- Generally keep active, but within your pain limits
- Re-introduce previously painful activities gradually over the next few weeks
- Maintain any exercise routine you may have been given by your physiotherapist
You will either be given a follow-up appointment to attend the Pain Clinic after your procedure, or be followed up by telephone. Whenever you come to the Pain Clinic, please bring all your usual medication or a list of what you are taking with you.
Telephone: 01256 377741
Fax: 01256 377665 Address: The Pain Team c/o The Hampshire Clinic Old Basing Hampshire RG24 7AL
Practice Manager: Karen: firstname.lastname@example.org Admin: Michelle: email@example.com Rob Baylis private secretary & medical legal work Name: Philippa Williams Email: firstname.lastname@example.org Tel / Fax: 023 9225 6300 The Pain Team Limited Registered Company Number: 07204359 Registered in England and Wales