Stellate Ganglion Block: Impact, Uses & Side Effects

SGB, or a stellate ganglion block, is a medical intervention in which an anesthetic medication is given to a cluster of nerves in the neck’s lower anterior aspect.

This procedure targets the stellate ganglion. It is a group of sympathetic nerves near the collarbones that provides nerve signals to the head, neck, arms, and upper chest.

Stellate ganglion blocks could help alleviate pain by injecting anesthetic medication into these areas. It could also address circulation issues, phantom limb pain, and cluster headaches.

Does SGB also work for Post Traumatic Stress Disorder (PTSD)? Given this procedure’s potential benefits and risks, understanding the uses and importance of stellate ganglion blocks is essential.

What Is Stellate Ganglion?

The Stellate Ganglion(SGB) is a part of the autonomic nervous system. It is responsible for controlling functions like heart rate, blood pressure, and sweating involuntarily. It is a collection of sympathetic nerves and could extend to the anterior of the transverse process of the C7 cervical vertebra.

Stellate Ganglion is oval-shaped but might also look like a star, with each person having one on each side of their neck. Stellate Ganglion may help regulate bodily functions without conscious effort, such as fight-or-flight responses. It is positioned near the collarbones and can influence various physical processes.

Understanding Stellate Ganglion Block

A Stellate Ganglion Block (SGB) is a targeted injection of anesthetic medication into the stellate ganglion.

This procedure aims to reduce pain in the head, neck, upper arm, and upper chest by disrupting the transmission of pain signals along these nerves.

An SGB could enhance circulation and blood flow to the affected arm, aiding in managing specific circulatory issues and modifying the activity of the sympathetic nervous system.

Stellate Ganglion Blocks are commonly used to diagnose sympathetically mediated pain conditions.

The SGB procedure involves the patient lying on a table. At the same time, the injection is guided by ultrasound or fluoroscopic imaging for accuracy.

It’s essential to discuss the potential risks, benefits, and expected outcomes with your healthcare provider before considering an SGB.

Stellate Ganglion Block For PTSD

SGB may help with PTSD by decreasing nerve growth factor levels. This effect could reduce norepinephrine levels and enhance sympathetic nervous system functioning.

For people not responding to traditional PTSD therapies, considering SGB as a potential intervention is advisable. It may improve the quality of life by addressing symptoms like anxiety, depression, and hyperarousal associated with PTSD. However, the precise mechanism through which SGB alleviates PTSD symptoms remains unclear.

Limited evidence regarding the clinical effectiveness of SGB for PTSD exists, with a Department of Defense study reporting a success rate of around 70%.

Another clinical trial revealed a reduction in PTSD symptoms among people who received SGB compared to those who received a placebo injection.

Although ongoing research is exploring the benefits and success rates of SGB as an alternative therapy for PTSD, behavioral health clinicians have recognized its potential as a treatment option for over a decade.

Impact Of Stellate Ganglion Block On Mental Health

SGB, or Stellate Ganglion Block, is a procedure that could be beneficial in treating mental health conditions, particularly in targeting the fear center of the brain. It could focus on addressing symptoms such as anxiety, depression, and hyperarousal by blocking the sympathetic nerve impulses that contribute to these mental health conditions.

This procedure is usually performed under an ultrasound to ensure accurate needle placement, with the outpatient procedure lasting around 10-15 minutes.

Presence Of A Stellate Ganglion

A stellate ganglion’s presence in people depends on the fusion of two specific ganglia in the neck and upper back regions. The fusion required is between the inferior cervical ganglion and the first thoracic ganglion. The cervical ganglion passes underneath the last vertebra of the neck, and the thoracic ganglion exits the spine at the level of the first thoracic vertebra in the upper back.

This fusion process is vital for the formation of the stellate ganglion. Interestingly, only 80% of people worldwide have a stellate ganglion due to this specific fusion requirement.

In the remaining 20% of people, these ganglia do not merge in a typical manner, resulting in the absence of a stellate ganglion.

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Uses Of Stellate Ganglion Blocks

Stellate ganglion blocks are used for various conditions and symptoms, including:

• Sympathetically Mediated Pain (SMP): Using stellate ganglion blocks extends to diagnosing sympathetically mediated pain (SMP), a neuropathic condition involving transmitting unidentified pain signals through the sympathetic nervous system to the brain.
• Complex Regional Pain Syndrome (CRPS): Both type I (formerly reflex sympathetic dystrophy) and type II (formerly causalgia) CRPS could be treated with stellate ganglion blocks.
• Peripheral Vascular Disease: Circulation problems in the arteries could be addressed using these blocks.
• Phantom Limb Pain: People experiencing pain in limbs that are no longer present may find relief with stellate ganglion blocks.
• Postherpetic Neuralgia: Pain that persists after a shingles outbreak might be managed with these injections.
• Chronic Post-Surgical Pain: Persistent pain following surgical procedures may also be targeted using stellate ganglion blocks.

The SGB might also be beneficial for conditions such as:

• Hyperhidrosis
• Raynaud’s syndrome
• Scleroderma
• Orofacial pain
• atypical chest pain
• Ménière’s disease
• intractable angina
• Refractory cardiac arrhythmia

Side Effects Of SGB

Potential complications following a stellate ganglion block procedure may include:

• Bruising and soreness or pain at the injection site are common, typically resolving within a few days.
• Tearing up, bloodshot eyes, and droopy eyelids may occur because of the proximity of the injection site to the eye area, but these effects are temporary.
• A stuffy nose, hoarse voice, or throat discomfort can result from the spread of the anesthetic medication, affecting nearby structures.
• Sensory changes in the hand or arm might occur due to the nerve-blocking effects of the procedure, causing temporary tingling or warmth sensations.

These effects are mild and temporary. However, some people might experience severe side effects like infection, bleeding, or nerve damage might occur.

Discussing the potential risks with the doctor before undergoing the SGB procedure is important.

Effectiveness Of Stellate Ganglion Blocks

The efficacy of stellate ganglion blocks in pain management varies. Some people might experience immediate pain relief, and others may find that their pain returns after the local anesthesia wears off.

In contrast, some people may report prolonged pain relief even after the initial effects of the anesthesia subside. The duration of pain relief might vary from hours to weeks, with some requiring multiple injections to maintain relief.

For those who respond well to the treatment, a series of injections every 1-2 weeks might prolong the pain-free period after each round of treatment.

However, it is essential to note that the number of injections needed for optimal pain management may vary significantly for different people.

Frequently Asked Questions

1. Can SGB Be Used for Conditions Other Than Pain Relief and PTSD?
   SGB could help manage pain from shingles affecting the head, neck, arm, or upper chest. There is some research being done on SGB to check its efficacy in managing other mental health conditions like depression, anxiety, and psychosis.
2. Are there any lifestyle changes or precautions needed before Undertaking SGB?
   Before undergoing SGB, specific lifestyle changes, and precautions are advisable. These may include abstaining from eating or drinking before the procedure, removing the necklace before the procedure, avoiding strenuous activities post-injection for 24 hours, and refraining from driving on the same day.
3. How Long Does the Effect of SGB Typically Last?
   The effect of SGB may vary among people. This could typically range from months to years. Sometimes, SGB might need repeating to maintain this relief from chronic pain.
4. Is There a Minimum Age Requirement for Receiving SGB?
   The minimum age for getting an SGB should be 18 years. The upper age limit for SGB injection can be 85. This decision is also based on a case-by-case assessment by healthcare providers, considering factors like medical history and condition severity.

Conclusion

Stellate Ganglion Block (SGB) is a medical procedure that could help treat different types of pain and circulation problems. It could also help manage complex regional pain syndrome.

If you’re worried about receiving a stellate ganglion block injection, don’t hesitate to ask your doctor about the procedure.

The doctor can guide you through the SGB injection process and explain the changes you could notice after a Stellate Ganglion Block, like a hoarse voice or appetite changes.

Seek immediate medical help if you experience any health issues after the SGB injection, such as swallowing issues and skin or body infections.