A cervicothoracic (stellate) ganglion block is a procedure used in pain medicine to improve pain and blood flow in the arm, chest, face and neck. It is only when conservative treatment (education, rehabilitation and medication) has not been successful.
The procedure involves an injection of local anaesthetic and steroid into a group of nerve cells (ganglion) in the neck. This particular group of cells is responsible for blood flow, sweating and pain transmission in the upper limb, neck and face. It is thought that the local anaesthetic and steroid interrupts the transmission of painfull nerve messages, decreasing pain.
This group of nerve cells sits close to some vital structures in the neck so the procedure has to be performed with either ultrasound or fluoroscopic (guidance). The structures nearby include the carotid artery, jugular vein, spine, lung and nerves that supply the voice box and diaphragm.
It is difficult to predict the length of time the procedure will gain pain relief in any one patient. Most trials using this technique are show varying period of pain relief. The procedure is to be used in conjunction with rehabilitation so that during the time the block works exercise and other techniques can improve and consolidate any gains.
This procedure is performed as a day patient. You will be prepared for theatre and placed in a theatre gown. Once you are on the operating table the anaesthetist will place a canulae in your arm and sedative drugs will be administered.
The procedure is performed under sterile conditions. A needle will be advanced under image guidance and once the ganglion is reached local anaesthetic and steroid is injected.