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Stellate Ganglion Block (Cervical Sympathetic Block)


A block that is performed under fluoroscopy to determine if the sympathetic nerve chain in the neck is the source of the patient’s arm pain. This is primarily a diagnostic block but it may provide pain relief in excess of the duration of the anesthetic.


A local skin anesthetic is given near the base of the neck on the affected side. A needle is inserted near the transverse process of the cervical spine (usually at the cervical-6 level) with the guide of fluoroscopy. Sterile tubing is attached to the needle and anesthetic medication is slowly injected through the tubing.

It takes less than thirty minutes for the procedure followed by evaluation and recovery for several hours.


The patient may note increased warmth and redness of the painful arm during and after the injection. The patient can expect hoarseness of their voice, redness of the eye, drooping of the eyelid and pupillary constriction for four to eight hours after the injection. Pain relief may be noted immediately. Duration of relief is variable. The patient must assess their pain relief over the first three to four hours after the injection and report this on a diary card.

Again as in above, one can repeat this block many times in the hopes of shutting the pain generation down. I only rarely do a permanent block at this area, due to the permanent changes of the eye and the voice, I usually will prefer to do a thoracic sympathectomy if necessary.

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