Monday, July 26, 2010

-Stellate Ganglion Block-

A mouthful, at the least.  I had my third block today... some of you may be wondering what is it and what does it do...
  • What is a stellate ganglion block?
A stellate ganglion block is an injection of local anesthetic in the sympathetic nerve tissue of the neck. These nerves are a part of the sympathetic nervous system. The nerves are located on either side of the voice box, in the neck.
  • What is the purpose of a stellate ganglion block?
A stellate ganglion block blocks the sympathetic nerves that go to the arms, and, to some degree, the sympathetic nerves that go to the face. This may in turn reduce pain, swelling, color and sweating changes in the upper extremity and may improve mobility. It is done as a part of the treatment of Reflex Sympathetic Dystrophy (RSD), Sympathetic Maintained Pain, Complex Regional Pain Syndrome and Herpes Zoster (shingles) involving an arm or the head and face.
How long does the stellate ganglion block take?
The actual injection takes only a few minutes.
 Well, I get mine with just some 'local anesthetic'.  No medication to make me relax... I just lay on the table, head back, and the surgeon feels my neck for the nerve.  Once she think she has it, she sticks the needle in my neck, and aspirates the needle to make sure there is no blood.  If there is, she is in a vein and not the nerve (which is a very bad thing, and if medication were to be injected, could have bad consequences).  
Then they slowly inject medication into my nerve.  Beside the initial injection, my experience is it doesn't hurt.  I get some tightness in my throat (because I am very thin), and then my eye slowly begins to droop.  It stays that way for the majority of the day.

However, the pain in my arm, neck, and jaw is gone from the time of injection until later that evening.  Some people experience longer and different effects.

  • What should I do after the stellate ganglion block?
You should have a ride home. We advise patients to take it easy for a day or so after the procedure. You can perform the activities that you can reasonably tolerate. Some patients may go for immediate physical therapy.
  • Can I go to work to work the next day?
Unless there are complications, you should be able to return to work the next day. The most common thing you may feel is soreness in the neck at the injection site.
  • How long the effect of the medication last?
The local anesthetic wears off in a few hours. However, the blockade of sympathetic nerves may last for many more hours. Usually, the duration of relief gets longer after each injection.
  • How many stellate ganglion blocks do I need to have?
If you respond to the first injection, you will be recommended for repeat injections. Usually, a series of such injections is needed to treat the problem. Some may need only 2 to 4 and some may need more than 10. The response to such injections varies from patient to patient.

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