Stellate Ganglion Blocks
Stellate Ganglion Block
What is a Stellate Ganglion Block?
Within our body are two different kinds of nerves - sympathetic and parasympathetic. These bear opposite functions to each other but are essential in controlling a variety of functions within the body. The sympathetic nerves bundle up in the neck to form what is called a ganglion. The stellate ganglion is formed by the fusion of a ganglion that is present in the lower part of the neck and one that is present in the upper part of the chest.
The nerves that emerge from the stellate ganglion supply blood vessels along with the pacemaker of the heart. If there is an alteration in the function of these blood vessels that is due to the nerves that emerge from the stellate ganglion, an anesthetic agent can be injected into the ganglion to stop this dysfunction. This is called stellate ganglion block.
Who needs a Stellate Ganglion Block?
Stellate ganglion blocks are used as a treatment method when managing pain in a number of different syndromes. Stellate ganglion block is performed to control pain and blood vessel function. It is useful in treating conditions such as reflex sympathetic dystrophy, angina that does not respond to maximum medical therapy, herpes zoster, phantom limb pain, Raynaud syndrome, and more. This treatment should be avoided in patients who have recently suffered a heart attack, those who have problems with blood clotting, slow heart rates or glaucoma.
What are the steps in a Stellate Ganglion Block?
Preparing for the Procedure
After obtaining consent for the procedure and explaining the risks and benefits, the patient is placed on their back and the neck is tilted slightly backwards. This exposes the neck where the injection is to be administered.
Locating the Stellate Ganglion
With the help of X-ray or ultrasound guidance, the specific point where the stellate ganglion is located anatomically is marked.
Performing the Injection
Local anesthetic is then injected directly into the stellate ganglion to block the function of the nerves completely. Absolute alcohol, or 100 percent alcohol, is then injected to destroy the stellate ganglion completely.
After a Stellate Ganglion Block
Following the procedure, the patient is observed for a couple of hours and then discharged home. The entire procedure can take up to an hour, although this is variable.
The use of ultrasound or X-ray guidance has significantly reduced the risk of any complications occurring, so risks are rare but worth knowing. Allergic reactions to the local anesthetic may occur. Accidental injection of the anesthetic agent into the neighboring structures may occur, but the use of ultrasound guidance has reduced this risk significantly. The local anesthetic injection may irritate the surrounding nerves, causing the patient to suffer from a hoarse voice and some breathlessness. Other, more rare complications include injury to the esophagus and to the lining of the lung, which can cause a pneumothorax, or air accumulation around a lung.