The stellate ganglion is part of the “sympathetic” network and is formed by the lower cervical and first thoracic ganglia and is located just in front of the head of the first rib in the chest area. The ganglion receives input from the paravertebral sympathetic chain and provides sympathetic nerve messages to the upper extremities, head, neck, and heart. By injecting a local anesthetic around the ganglion, different types of pain, swelling and vasomotor dysfunctions of an extremity can be diagnosed and then treated. This is often referred to as “Reflex sympathetic dystrophy” (RSD) is a clinical syndrome of variable course and unknown cause.. This condition is often the result of trauma or surgery.
Stellate ganglion blocks are performed under fluoroscopic guided x-ray allowing the physician to ensure the correct location with a sterile surgical field.
Indications for stellate ganglion blocks include reflex sympathetic dystrophy of the upper extremities, Raynaud syndrome, of the upper extremities, herpes zoster or shingles of the face or neck, hyperhidrosis of the neck of an upper extremity, and upper extremity pain due to arterial insufficiency. Pain due to arterial insufficiency can be treated with a stellate ganglion block, but this would have no effect on someone with venous insufficiency.
Post-operative care instructions will be given regarding healing and signs of infection. As well as any medications that may be prescribed. Different types of therapies may also be used: such as Physical Therapy to strengthen the affected areas and supportive structures.
The duration of relief is variable. The patient must assess their pain relief over the first three to four hours after the injection and report this to the physician.