The stellate ganglion block involves administering a local anesthetic to a small group of nerves in the lower anterior part of the neck to reduce pain in the face, chest, and the arm on the same side. It can sometimes be used as a diagnostic block, and in other cases, it can serve as a therapy on its own.

The stellate ganglion block can be used in the following conditions:

  • Herpes zoster, or shingles (early treatment is especially important to prevent long-term complications)
  • Chronic pain in the upper limb and face
  • Circulatory diseases of the upper limb – e.g., Buerger’s disease (thromboangiitis obliterans), atherosclerosis, Raynaud’s syndrome, hyperhidrosis (sweating of the palms)
  • Chronic pain conditions of the upper arm – e.g., in complex regional pain syndrome (CRPS)
  • Post-Covid anosmia, dysgeusia

When should the procedure not be used?

  • In the case of local infection/inflammation
  • Used with caution in severe lung disease or diaphragmatic paralysis
  • Other severe anatomical abnormalities

What to expect during the stellate ganglion block procedure?

The procedure is performed on an outpatient basis, meaning the patient can go home with an escort after a 15-30 minute rest and observation period following the intervention. The procedure is carried out in a clinic, always under ultrasound guidance. There is no need for anesthesia as the procedure is done with a very small needle, smaller than the venous cannula required for anesthesia.

What happens after the procedure?

There is no need for postoperative pain relief, and the patient can return to their normal lifestyle. Temporarily (for about 1-2 hours), one pupil may be dilated more than the other, so driving is not recommended.

What does the complete treatment involve?

Depending on the condition, the stellate ganglion block can be used as a single injection, as a diagnostic intervention, but in certain conditions where it is used for therapeutic purposes, multiple repetitions may be necessary.

How long does the procedure take?

The patient lies on their side, and the treating doctor examines the neck with ultrasound for 2-3 minutes, followed by the injection, which takes about 20-30 seconds.

Temporary side effects

Success of the stellate ganglion block can be seen if the pupil on the same side becomes narrower – this may cause blurred vision, and the same side limb may become warmer, and the face may flush. These are temporary changes that disappear within a few hours as the anesthetic wears off.

Complications

Rare: Local sensitivity

Very rare: Headache, bruising/hematoma, infection/inflammation at the site of intervention, pneumothorax, allergic reaction, new onset of pain, worsening pain condition

Especially rare: Seizure, nerve damage