Stellate Ganglion Block
WHAT IS A STELLATE GANGLION BLOCK?
A stellate ganglion block (SGB) involves injecting local anaesthetic into the stellate ganglion, a nerve bundle in the neck located at C4 and C6, connected to the fight or flight system. By blocking the sympathetic nerves through this procedure, it reduces pain and enhances blood flow to the face, neck, and arms. SGB is commonly used to treat conditions such as complex regional pain syndrome (CRPS), post-traumatic stress disorder, post-herpetic neuralgia, and facial pain.
HOW IS THE PROCEDURE PERFORMED?
During your procedure, an anaesthetist will provide intravenous sedation to help you relax. This minimally invasive process takes place in a hospital theatre or day procedure centre, with specialised imaging guidance. This enables your doctor to safely position a needle near the stellate ganglion nerve bundle and administer a small amount of local anaesthetic.
HOW LONG DOES THE EFFECT LAST?
Results and relief have been seen within 30 minutes and can last from a few months to years.
WHAT SHOULD BE DONE BEFORE THE PROCEDURE?
Prior to the procedure, you may need to stop blood thinning products as directed by your doctor. Other regular medications can be taken with a sip of water on the morning of the procedure. Insulin-dependent diabetics will likely be prioritised on the list and should bring their insulin for potential administration after the procedure. Hospital staff will call you the day before the procedure to provide fasting and admission times. DO NOT eat, drink, smoke, or chew gum before the procedure. Arrange for someone to drive you home afterward, as you won’t be able to drive for 24 hours due to the received anaesthesia.
WHAT IS THE NEXT STEP AFTER THE PROCEDURE?
After the procedure, you will spend a short time in the recovery ward until you complete a satisfactory sip test of water, and then you can be discharged home with a carer. Expect temporary side effects such as “Positive Horner’s Sign,” which causes drooping of the eyelid and mouth on the injected side. You may also experience nasal congestion, a hoarse voice, and a headache, but these will resolve on their own. Gentle activity and rest are recommended for the first 24 hours post-procedure. For local pain, you can use ice on the area for 10 minutes at a time, and remove the dressing 24 hours after the procedure, monitoring the site until it heals. Showering is allowed 24 hours after the procedure. If you feel well enough, you may return to work the day after the procedure.
WHAT ARE THE RISKS AND SIDE EFFECTS?
Serious side effects and complications are rare. The most common problem after the procedure is having pain in the area of the procedure for 1 to 3 weeks. Please contact your local GP or the rooms if you have any allergic reaction to the medication administered in hospital, signs of infection at your procedure site.