What Is a Stellate Ganglion Block?

A stellate ganglion block involves injecting a local anesthetic near a small nerve group in the lower front part of the neck to reduce pain in the face, chest, and the arm on the same side. It can be used diagnostically or as a therapeutic treatment.

What Conditions Can It Treat?

A stellate ganglion block may be used for:

  • Herpes zoster (shingles), especially early treatment to prevent long-term complications
  • Chronic pain of the upper limb and face
  • Circulatory disorders of the upper limb (e.g., Buerger’s disease, atherosclerosis, Raynaud’s syndrome, hyperhidrosis of the palms)
  • Chronic upper limb pain conditions (e.g., Complex Regional Pain Syndrome – CRPS)
  • Post-COVID loss of smell

When Is It Not Recommended?

  • Local infection
  • With caution in severe lung disease or diaphragm paralysis
  • Certain severe anatomical abnormalities

What Happens During the Procedure?

The procedure is performed on an outpatient basis. After 15–30 minutes of observation, the patient can go home with an escort. It is performed under ultrasound guidance.

General anesthesia is not required, as the procedure uses a very fine needle, smaller than those used for IV cannulation.

What Happens After the Procedure?

No post-procedure pain medication is usually needed, and patients can return to normal activities.

Temporarily (for about 1–2 hours), one pupil may become smaller or larger than the other, so driving is not recommended during this time.

How Many Treatments Are Needed?

Depending on the condition, it may be used as a single diagnostic injection or repeated multiple times for therapeutic purposes.

How Long Does It Take?

The patient lies on their side, the neck is examined with ultrasound for 2–3 minutes, and the injection itself takes about 20–30 seconds.

Possible Side Effects

A successful block may cause temporary narrowing of the pupil on the same side, blurred vision, warmth in the limb, and facial flushing. These effects are temporary and resolve within a few hours.

Complications

  • Rare: local tenderness
  • Very Rare: headache, bruising/hematoma, infection, pneumothorax, allergic reaction, new or worsening pain
  • Extremely Rare: seizure, nerve injury