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When an injection of an anesthetic is instilled onto the stellate ganglion nerves, this will “block” sympathetic signals in the area, which leads to pain relief.

Several conditions are treated by the stellate ganglion block. These include:

. Complex regional pain syndrome (CRPS)
. Vascular insufficiency
. Raynaud’s syndrome
. Phantom limb pain
. Neuropathic pain
. Cancer pain
. Postherpetic neuralgia
. Acute herpes zoster
. Atypical facial pain
. Trigeminal neuralgia

The stellate ganglion block can work in three ways:

. Diagnostic - To determine if the pain is related to the sympathetic nerves or not.
. Prognostic - To determine if a neurolytic procedure would help, such as chemoneurolysis or radiofrequency ablation.
. Therapeutic - To treat many painful conditions.

If you are taking blood-thinning agents, be sure to notify the pain doctor in Los Angeles, as the medicines will need held before for several days. In addition, you should arrange for someone to drive you home. Since mild IV sedation will be used, do not eat or drink after the midnight the night before the procedure. When you arrive at the medical facility, a nurse will go over the procedure, and have you sign a consent form. In addition, an IV catheter will be placed in your arm, and you must change into a gown.

The treatment is an outpatient procedure, and it is done with the patient lying on his or her back. Monitoring devices are used to assess for blood pressure, oxygen level, and heart rate. The skin will be cleaned with an antiseptic solution, and then anesthetized with a numbing agent. After the anesthetic takes effect, the doctor inserts a small needle at the side of the neck using x-ray guidance. Once in position, an anesthetic (bupivacaine or lidocaine), with or without a corticosteroid, is injected onto the nerves.

The entire procedure takes less than 15 minutes, and a dressing will be placed over the injection site. Expect the site to be tender for around 24 hours. With a successful block, the patient will experience immediate pain relief, a warm sensation in the arm and face on the same side of the procedure, and temporary drooping of the eye on that side. The tenderness, eye dropping, and skin warmth will wear off in 3-5 hours.