The stellate ganglion is a portion of your sympathetic nervous system. It lies on either side of the lower neck (cervical level 7) and controls sympathetically mediated pain of the face, neck, upper extremity and upper chest. A stellate ganglion block may be used to control pain caused by nerve injuries to the face, neck, arm and upper chest. It may also be used to control the pain of reflex sympathetic dystrophy (RSD), Raynaud's syndrome of the arm, and some sympathetically mediated cancer pain.

Prior to the procedure, an intravenous line (IV) will be started and you will be placed on a monitor that will check your blood pressure and heart rate. You will be asked to lie on your back. A nurse will give you some sedating medication through your IV and will monitor you throughout the procedure. Temperature sensors will be placed on your arms to record changes in skin temperature as the block begins to work.

A radiology technologist will use an X-ray machine to locate the exact areas targeted for the procedure. Your neck will be cleaned with a special solution and draped with sterile drapes. Your face may be partially covered for a short time. You will feel a burning sensation for 10-15 seconds as the doctor injects local anesthetic to numb the skin at the injection site. You will feel the doctor press on the side of your neck as the needle is advanced down to the stellate ganglion and local anesthetic is injected to block the nerve. When finished, you will be taken to the recovery room and asked to lie down for about 30 minutes before preparing to go home.

• The procedure may not help your pain.
• Small risk that your pain may become worse.
• You may experience bruising at the injection site.
• Small risk of bleeding or infection at the injection site.
• The stellate ganglion lies close to several large blood vessels in your neck. There is a small risk of puncturing one of these blood vessels and causing bleeding which might require surgery to repair.
• In rare instances, damage to spinal nerves or the spinal cord is possible, resulting in paralysis or partial muscle weakness or persistent numbness.
• The dome of the lung is close to the stellate ganglion. Although very rare, perforation of the lung is possible and may require surgery to repair.
• Rarely, reactions to the anesthetic drugs can cause flushing, ringing in your ears, or in very rare instances, seizures or respiratory depression.
• Allergic reactions to medications may cause your heart and breathing to stop or cause death.

• In almost every case, you will experience what is known as a Horner's syndrome after a stellate ganglion block (constriction of the pupil, drooping eyelid, and a red eye). The Horner's will resolve slowly over the next few hours and will not cause permanent problems.
• You may occasionally experience a temporary numb sensation on one side of your throat and have difficult swallowing or feel like you have a "lump in your throat" for several hours after the block. This will be gone within a few hours.
• You may feel a sensation of warmth in your face, arm or upper chest on the side of the block. This is an indication that the block has been effective.
• If after a few hours of leaving the Center any of these symptoms continue or worsen, please call The Pain Treatment Center or the on-call doctor.

It is not possible to predict to what extent, if any, stellate ganglion block will relieve your pain. However, this block is known to produce dramatic relief in some patients suffering from sympathetically mediated pain. In many individuals, pain will return gradually. When this occurs, the block may be repeated or other procedures considered.

To be most effective, stellate ganglion block should be combined with programmed exercises. Your pain doctor can discuss types of exercises with you. Your doctor may also recommend that you scheduled an appointment with our Behavioral Medicine doctors to discuss stress management techniques. You may also be asked to stop smoking.