A stellate ganglion block is an injection of local anesthetic into the front of the neck that is typically ordered for pain located in the head, neck, chest or arm caused by sympathetically maintained pain (reflex sympathetic dystrophy), causalgia (nerve injury), herpes zoster (shingles), or intractable angina.
The stellate ganglion is a collection of sympathetic nerves found at the level of the sixth and seventh cervical vertebrae, which are the last vertebra of the neck. They are part of the sympathetic nervous system and supply the face and arm. These nerves are not involved with feeling or movement. Sometimes, after a nerve is sensitized by trauma, infection, or other causes, the sympathetic activity can cause pain.
Blocking the sympathetic activity by anesthetizing the stellate ganglion may stop the pain. A stellate ganglion block, more commonly known as a sympathetic block, is an injection of local anesthetic into the front of the neck.
During a stellate ganglion block, the patient is usually sedated while pain-relieving medication is injected to the region where the ganglion lies. This reduces the release of norepinepherine, activating the pain sensitive nerves, which in turn reduces the pain.
A stellate ganglion block is performed for one of two reasons, either as a diagnosis or pain management. Most commonly, the procedure is done to:
- Diagnose the cause of pain in the face, head, arms, and chest.
- Manage pain in the head, neck, chest, or arm caused by nerve injuries, the effects of an attack of shingles, or angina.
- Reduce sweating in the face, head, arms, and hands.
- Treat reflex sympathetic dystrophy, sympathetic maintained pain, or complex regional pain syndrome.