Stellate Ganglion Nerve Block Injections


The stellate ganglion is a group of nerves in the neck. The stellate ganglion refers to the mass of nerves formed by the synthesis of the inferior cervical and the first thoracic ganglion. It is located on the anterior surface of C7. Stellate ganglion blocks are indicated for certain conditions such as complex regional pain syndrome (also known as reflex sympathetic dystrophy), shingles, phantom limb pain, Raynaud’s phenomenon, and scleroderma. If nerve block injection is recommended, the most common procedure includes injection at C6 with relatively large amounts of medication. A large volume is needed so that the drug can be diffused downwards, where the stellate ganglion is. There is more risk when injecting the medication directly at C7. 

Treatment:

As with all types of chronic nerve pain, there are many treatment options available including cryotherapy (extreme cold), medications and nerve blocking injections. Nerve Block injections involve injection of a numbing solution into a selective nerve in an attempt to treat and manage pain. The injection can include lidocaine or marcaine. Nerve block injections are used to effectively “turn off” such nerves, and thus reduce any associated inflammation. The effect of these injections lasts between one and four weeks and can be repeated as required. With some conditions however, patients report a total reduction in pain since the initial over- activity of the nerve has been counteracted. In some instances, the patient may experience a more long term loss of pain as a result of localized anesthesia.

The types of medications used are not predetermined, since many options are available. Of course, ultrasound, fluoroscopy, and CT (image-guided injections) may work best, since surface anatomy may not be enough to target the extremely small surface area of the nerves in question.

Remember, nerve blocks are not the best treatment for all pain types. Even when they are appropriate, they are usually more effective as part of a more comprehensive treatment strategy.

Depending on the circumstances, complete destruction of the nerve (as opposed to temporary numbing through a local anesthetic) could be considered. This is referred to as a rhizotomy. Aside from the obvious complications of nerve destruction, permanently damaging a nerve may inadvertently and inevitably damage the soft tissue adjacent to that nerve as well.

sources:

http://my.clevelandclinic.org/anesthesiology/pain-management/treatments-procedures/stellate-ganglion-block.aspx

http://www.frca.co.uk/article.aspx?articleid=100538

http://www.e-algos.com/stellate-ganglion-block/

 

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