Stellate Ganglion: The stellate ganglion is a “star shaped” nerve bundle in the front of the cervical spine (neck), near the “Adam’s apple” and voice box.  It is a relay system that sends nerve signals, including pain, from the head, face, neck, upper extremity (i.e. arm, hand) and even the heart to the brain.  By “blocking” these pain signals at the stellate ganglion with a nerve block, they will no longer travel up to the brain and cause you to “feel” the pain.

Indications for Stellate Ganglion Block (SGB): This injection is usually performed for patients with upper extremity (i.e. hand/arm) pain from a “sympathetically mediated” pain, such as that due to Reflex Sympathetic Dystrophy (RSD) or Complex Regional Pain Syndrome (CRPS). This injection is also very effective for patients suffering from shingles related pain of the face, neck and upper extremity (i.e. arm/hand) regions.

Technique: At SCCPM, stellate ganglion blocks are performed at the surgery center under live x-ray (fluoroscopy) for safety and accuracy.  The doctor will usually order IV sedation (i.e. “twilight sleep”) as an option for your comfort.  You will be checked in at the surgery center and brought into the operating suite, where you will be greeted by the doctor and registered nurse.  After placing monitors (e.g. blood pressure cuff, EKG, pulse oximeter, etc) on you, the nurse will give you IV sedation (if ordered).  Afterwards, the doctor will begin by “numbing” the injection site (at an area in front of your neck, near the “Adam’s Apple”) with a local anesthetic.  Afterward, with the aid of the fluoroscope, Dr. Lee will perform the actual injection(s), in which a local anesthetic and steroid combination is injected.  After appropriate monitoring, you will then be transferred to the recovery unit before going home with a family member or friend.  You are encouraged to “take it easy” for the rest of the day, and to follow the post-procedure instructions ordered by Dr. Lee.  You will be able to resume your normal activities the next day.

Pain Relief Response and Duration: Most patients can expect a response at the first injection. In fact, the local anesthetic will usually provide relief immediately. The steroid medication is meant to prolong and improve the relief with the local anesthetic. You may require more than one injection for long term relief, depending on the severity and duration of your pain. You and Dr. Lee will decide exactly on the number and course of your treatment. Like any medication, the local anesthetic and steroid will “wear off” with time and you may require repeat injection(s). For most patients, one or a series of injections will allow pain relief for months and even a year or more. Unfortunately, Dr. Lee will not be able to predict your response as each patient’s disorder and severity is unique.