c1- Stellate Ganglion Block

1. What is the Stellate Ganglion, what is its function, and where is it located?

The Stellate Ganglion is a bundle of nerves located on either side of the neck, adjacent to the esophagus. These nerves control the sensation of pain and blood flow to the neck, face, and arms.

 

2. In which conditions is the Stellate Ganglion Block applied?

• Diseases related to the blood vessels of these organs

 • Complex Regional Pain Syndrome, Reflex Sympathetic Dystrophy

• Herpes Zoster (Shingles)

• Paget's Disease

• Phantom limb pain

• Raynaud's Disease

 • Scleroderma

 • Thrombosis

• Shoulder-arm syndrome

3.  What preparation is required for the procedure?

Food and liquids should be discontinued 4 hours before the procedure. However, you should take the medications you are using for other diseases with a small amount of water if approved by your doctor. Come without wearing any jewelry such as necklaces, earrings. You should come with a relative who will accompany you after the procedure.

4. What are the benefits of the procedure?

 Usually, within 15-20 minutes after the procedure, the pain begins to decrease. At the same time, the temperature of the affected arm may also start to increase due to increased blood flow.

5. How is it performed?

After establishing a venous access, the patient is taken to conditions similar to an operating room, and measurements of pulse, blood pressure, blood oxygen level, and respiration are taken. These values are continuously monitored throughout the procedure. The patient lies on their back, and sedative medications are administered through the IV. The area is cleaned and covered with antiseptic solutions. The entry point of the needle in the neck is identified and verified through an imaging device. After numbing the entry point with a local anesthetic, a dye is administered to re-verify the spot under imaging, and a local anesthetic with steroid mixture is injected to perform the block.

6. What can happen after the procedure?

There may be hoarseness and a sensation of pressure in the throat. You may experience an increase in warmth and dryness in your face. Drooping of the eyelid on the side of the procedure, tearing, and pupil constriction can also occur. However, all these are temporary and resolve within a few hours. The immediate reduction in pain and other symptoms after the procedure is an indicator of its success.

7. What is the purpose of the Stellate Ganglion Block?

 The purpose of the block is to interrupt the nerves of the sympathetic nervous system in the neck. The blockage of sympathetic nerves reduces complaints such as pain, swelling, redness, and sweating, and helps improve the movements of the arm.

8. How long does the procedure last? The procedure lasts 15-20 minutes and is performed under operating room conditions.
9. Is the procedure painful?

During the procedure, both the needle entry site is numbed, and sedative medications are administered through the IV, so you will not feel pain.

10. What should I do after the procedure?

Rest is recommended for 1-2 days after the procedure. You can engage in activities within the home that do not tire you. It is preferable not to go to work during this time.

11. Can I go to work the day after the procedure?

You can usually start work the day after the procedure. However, if you have hoarseness or a sensation of pressure in your throat, it may be beneficial to rest for one more day.

12. How long does the effect of the procedure last, and how many injections are required?

Analgesic efficacy lasting for months can be achieved after repeated blocks. Some patients are treated with 1-2 injections, while others may not experience any effect.

13. Will the block benefit me? It is unpredictable how each patient will respond. Effectiveness is higher in patients who seek treatment early, while the success rate is lower in patients who have had symptoms for 6 months or more.
14. What are the risks and side effects?

 Although the procedure is extremely safe, risks, side effects, and potential complications that can be seen with any intervention may rarely occur with the Stellate Ganglion Block. The most common side effect is pain at the site of the procedure, which is temporary. Other risks include bleeding, infection, injection into nearby vessels or organs, epidural or spinal injection, drooping of the eyelid on the same side, redness in the eye, hoarseness, sensation of pressure in the throat, hypotension, and temporary loss of sensation in the arm. These side effects are extremely rare.

15. Who should not have a Stellate Ganglion Block?

 It is not administered to patients who have allergies to the medications used during the procedure, those who are taking blood thinners such as Coumadin, Plavix.