Stellate Ganglion Block

A minimally invasive procedure to relieve pain and increase circulation

The stellate ganglion is a collection of nerves in the neck. These nerves can become painful or swollen as a result of several conditions, such as:

• Complex regional pain syndrome, a form of chronic pain
• Complications from arterial cannulation, a method of measuring blood pressure through a thin, flexible tube called a catheter
• Herpes zoster, also known as shingles, a reactivation of the virus that causes chickenpox
• Phantom limb pain, a feeling of ongoing pain in an area after a limb has been amputated
• Post-herpetic neuralgia, pain that can linger after a shingles rash disappears
• Raynaud’s disease, a rare disorder that causes blood vessels to narrow in a particular area, usually the fingers or toes

A stellate ganglion block involves injecting a local anesthetic and steroid medication around the stellate ganglion nerves. This injection can relieve pain and swelling in the area and increase circulation to the head, neck, upper arm, and upper chest.

There is a small risk of complications from a stellate ganglion block, although these are rare. Possible complications include:

• Pain or bruising at the injection site
• Risk of injection into a blood vessel, which can cause a seizure or convulsions
• Temporary weakness or numbness from the neck down

Pain Management Service, Newton-Wellesley Ambulatory Care Center
159 Wells Avenue
Newton, MA 02459
Phone: 617-243-6142

What to Expect From Your Stellate Ganglion Block

When you arrive for your procedure, one of our nurses will speak with you about what your back or neck pain is like and how you manage daily activities. We’ll record the following vital health information:

• Allergies
• Blood pressure
• Brief health history
• Medications you’re currently taking
• Pulse
• Temperature
• Weight

It’s especially important to tell your nurse if you:
Are allergic to contrast dye, Betadine (iodine), or latex
Currently take blood thinners
Have diabetes or could be pregnant

Next, you’ll discuss the procedure with your doctor and go into the X-ray room, where we’ll help you onto a table. Once you’re comfortable, we’ll clean your skin with an antiseptic. Then your doctor will place a needle near the affected nerve using X-ray guidance. Once the needle is in place, your doctor will inject a mixture of steroid medication and an anesthetic around the stellate ganglion nerves. You’ll need to breathe normally and stay still during the procedure, which will only take a couple of minutes.

You should plan to stay with us for about 45 minutes after your procedure as we monitor how you respond to the medications. You may experience a number of side effects from the injection, such as:

• Drooping eyelid
• Eye redness or watering
• Stuffy nose
• Hoarse voice
• Trouble swallowing
• Soreness or swelling at the injection site
• Warmth or tingling in the arm or hand

These side effects will go away within several minutes to several hours as the anesthetic wears off.

When You Go Home After Your Stellate Ganglion Block

You will need a ride home after your procedure. You won’t be allowed to drive for three hours after your stellate ganglion block. You should not eat or drink anything for two hours after the injection. When two hours have passed, start by sipping water and slowly progress to solid food, making sure that you can swallow normally.

Go to your nearest emergency room right away if you experience any of the following symptoms once you go home from your stellate ganglion block:

• Pain with breathing
• Severe swelling of the neck
• Trouble breathing

If you notice any pain or discomfort, use ice at the injection site and take over-the-counter pain medications as directed by your doctor. Report any increase in pain, fever, or chills to your doctor. You’ll need to make an appointment for follow-up evaluation or to repeat the procedure in two to four weeks.

Talk to your doctor for more information about receiving a referral for a stellate ganglion block, or call us at 617-243-6142 to request an appointment.