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Stellate Ganglion Block

 
 
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What is a stellate ganglion block?

The stellate is a group of nerves in the neck area. A stellate ganglion block is an injection of a local anesthetic (pain-relieving medication) around this group of nerves to relieve pain. The pain relief will affect one side of the head and neck, the upper arm and the upper part of the chest on the same side of the body.

A stellate ganglion block may be performed to decrease pain and increase the circulation and blood supply to the affected arm. A stellate ganglion block may be performed for people who have circulation problems or the following nerve injuries:

  • Reflex sympathetic dystrophy
  • Causalgia
  • Herpes zoster
  • Phantom limb pain

Before the procedure

First, you will meet with a physician in the Pain Management Center for an evaluation. A health care provider will explain the procedure in detail, including possible complications and side effects. The health care provider also will answer any questions you may have.

The day of the procedure

  • You must fast for 6 hours before the procedure. You may have clear liquids until 2 hours before the procedure, but do not eat within 6 hours of your appointment.
  • If you have diabetes and use insulin, you must adjust the dosage of insulin the day of the procedure. Your primary care physician will help you with this adjustment. Bring your diabetes medication with you so you can take it after the procedure.
  • Discontinue your pain medication (if any) 4 hours before the time of your appointment. Continue to take all other medications with a small sip of water. Bring all medication with you so you can take it after the procedure.

Please note:
Do not discontinue any medication without first consulting with your primary or referring physician.

  • You will need to bring a responsible adult with you to drive you home after the procedure. You should not drive or operate machinery for at least 24 hours after the procedure.
  • An intravenous (IV) line will be placed in a vein in your arm before the procedure. Mild sedatives (medications to relax you) will be given through the IV.

During the procedure

  • You will be lying on your back, with your head tilted slightly back and supported on a thin pillow.
  • Your neck area will be cleansed with an antiseptic solution.
  • A bandage may be placed over the injection site.

After the procedure

  • You will lie down in a recovery room for about 15 to 30 minutes for observation.
  • A nurse will check your blood pressure and pulse.
  • Small stickers will be used to record the skin temperature of your thumbs.
  • The nurse will ask you how much pain is relieved.
  • The nurse will review your discharge instructions with you and you will be able to go home.
  • A responsible adult must drive you home.

Discharge instructions

  • Do not drive or operate machinery for at least 24 hours after the procedure.
  • When your voice has returned to normal, you may eat. Start by first drinking a sip of water with a straw and gradually eat solid foods when you are able. Drink liquids through a straw for at least 3 hours after the procedure. You may resume your normal diet.
  • Do not engage in any strenuous activity.
  • You may shower or bathe without restriction.
  • You may remove any bandages in the evening before going to bed.

What can I expect after the procedure?

You may experience any of the following side effects up to 8 hours after the procedure:

  • Drooping eyelids
  • Red or "bloodshot" eyes
  • Tearing
  • Nasal stuffiness
  • Hoarse voice
  • Sensation of a "lump" in your throat
  • Difficulty swallowing
  • Sensation of warmth or tingling in your arm or hand

These symptoms will disappear and you may have mild discomfort once the local anesthetic wears off. This usually lasts two or three hours, if it occurs. Apply ice to the area the day of the procedure and moist heat the day after the procedure if the discomfort continues.

When should I call for help?

If your pain increases, or if you experience fever or chills, contact your health care provider.

When should I go to the emergency room?

Have someone take you to the nearest emergency room immediately if you experience either of the following:

  • Difficulty breathing, such as shortness of breath or pain when breathing
  • Severe swelling of the neck

Tell the emergency room staff that you just had a stellate ganglion block. A physician must evaluate you for bleeding or respiratory complications.

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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 11/12/2004