frequent procedures
 

STELLATE GANGLION BLOCK
Stellate ganglion block is a procedure that attempts to block the sympathetic activity in the upper extremity and achieve pain relief. The stellate ganglion is a ganglion lying anterior to the vertebral body of the C7 vertebra approximately, and on each side of the midline. It is a “relay” site and is able to receive sympathetic ganglion fibers from the upper extremity of the ipsilateral side. The ganglion is accessed with the patient lying supine and with placement of a tiny middle into the vicinity of that ganglion in a very quick and brief procedure that is preceded by manual displacement of vital tissue and vessels prior to the injection. The injection is done with about 10 cc of local anesthetic that is injected, and the effect of the injection is quick and effective in blocking the sympathetic chain, and relieving pain in the upper extremity affected with adequate placement.

Following a successful procedure of a unilateral ptosis and temporary, as well as color change with increased partition of the skin of the upper extremity on the ipsilateral side, as well as increase in temperature and reduction of pain on the upper extremity involved, there is also increased partition of the capillary of the sclera of the eye affected, as well as unilateral pupillary constriction, otherwise called pinpoint pupil or myosis. There may also be enophthalmos. What happens that may be present include nasal congestion and facial anhidrosis. It is important to note that because of a _____fiber called bundle of Kuntz, these signs may be present without complete interruption of the sympathetic nerves of the upper extremity involved occurring. Pain relief is usually documented in these patients.

INDICATIONS: Common indications for stellate ganglion block includes reflex sympathetic dystrophy and causalgia, ______infections, shingles, post sympathetic neurology, vascular insufficiency as in frostbite or vasospasm of the upper extremity on the affected side, or Raynaud disease.

CONTRAINDICATIONS: Use of anticoagulants like Coumadin and Heparin may be a related contraindication in this procedure. Coumadin should be stopped about three days prior to the injection being done, and may be resumed as soon as the procedure is completed.

COMPLICATIONS: Complications are very rare in this procedure when done with experience. Complications of this procedure include intradermal injection, which could result in a spinal block, intravascular injection, which could result in spread of local anesthetic including CNS and cranium, resultant impaired mental status and myoclonic effects.

Patients do not require sedation for this procedure to be done because it is usually completed within two to three minutes. However, if the patient is anxious, sedatives may be made available to the patient on request.

<< Back To Procedure List