University of Wisconsin Interventional Pain Program - Cervical Sympathetic Nerve Block (Stellate Ganglion Block)

Cervical Sympathetic Nerve Block (Stellate Ganglion Block)

A cervical sympathetic nerve block is a specialized test used to diagnose and treat pain arising from sympathetic nerves in your neck near the spine. It can be done on either the right or left side of the body. Sympathetic nerves control sweating, heart rate, blood vessels, pupil dilatation, movement of food through the intestines, and many other body functions. Sometimes the sympathetic nerves do not function correctly and cause pain. The purpose of this nerve block is to find out if your sympathetic nerves in your neck are causing your arm or shoulder pain. The procedure is a diagnostic test. Learning more about the cause of your pain can help your doctor decide on the best treatment for you.

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What to Expect:

The test is performed in an operating room equipped with an X-ray machine. Before the test, you will change into a hospital gown and an IV will be started in your arm. A sedative medication will be given through the IV to make the procedure as easy as possible. However, you will remain awake throughout the test.

You will lie on the X-ray table on your back. We will monitor your blood pressure, heart rate, and oxygen saturation throughout the procedure. We will place a pillow under your neck to position it so your neck is extended. Your neck will be thoroughly cleaned. Then, your neck will be covered with a sterile drape. Using the X-ray machine, your doctor will carefully guide a thin needle into your neck near the spine. Your doctor will inject some X-ray(contrast) dye through the needle to verify the correct position of the needle. X-rays will be taken. Then local anesthetic (numbing medicine) will be injected. During the test, you will be asked to lie very still and not talk. The test usually takes 30 to 45 minutes.

During and after the test, your doctor will monitor the temperature of your fingertips on both hands. This is done using a small sensor on your finger. The sensor will stay on for approximately 30 minutes.

Recovery:

When the test is complete, you will go to the recovery room where nurses and your doctor will monitor you for 30 to 60 minutes.

Your driver will take you home. Sometimes your referring doctor will advise you to go to physical therapy following the test.

You can expect the following to occur on the side of the procedure after it is completed:

• Watery, red eye
• Dialated pupil
• Droopy eyelid
• Droopy face
• Hoarse voice

These symptoms will only last for a few hours after the test.

You can expect some soreness at the injection site for the next 2-4 days.

You will be given a pain log to complete for the next 14 days. This will let us know if and how much your pain was decreased. If you do not fill out and send back your pain log, we cannot do more procedures/tests on you.

You may have changes in the sensation, color, or temperature of your arms for several hours after the test. Please note any changes on the pain log because this information is very important to your referring doctor.

You should continue to take your routine medicines.

Contact your referring doctor’s office to make an appointment to discuss the results of this test. Your doctor will get a report of the procedure.

If you have any unusual problems related to this procedure or if you develop new symptoms after the injections or any signs of infection, please call Joyce at (608) 444-7421, Maureen at (608) 262-0350, or Cindy at (608) 265-1729.

Signs of infection:

• Fever greater than 100.4 F by mouth for 2 consecutive readings 4 hours apart
• Increased redness, swelling around the injection site
• Any drainage from the injection site