Cervical Sympathetic Nerve Block (Stellate Ganglion Block)
The purpose of the nerve block is to find out if your sympathetic nerves are causing your pain. A stellate ganglion block is a test to diagnose and treat sympathetic dependent pain in your hand, arm or shoulder. The pain may come from the nerves in your neck near the spine. These nerves control sweating, heart rate, blood vessels, pupil dilatation, movement of food through the intestines, and many other body functions. Sometimes these nerves do not work right and cause pain. It can be on either side of your body. Learning more about the cause of your pain can help your doctor decide on the best treatment for you.
1. 1 week before the block
- You will need to stop taking aspirin. If you take it for your heart or blood vessels as prescribed by your doctor, you will need a written note from your doctor saying it is ok to stop taking your aspirin.
- If you take Plavix® (clopidogrel), you will need to stop taking it. Again, you will need a written note from your doctor saying it is ok to stop taking your Plavix®.
2. 3 days before the block
- You cannot take herbal medicines, fish oil, or Vitamin E.
3. 24 hours before the block
- You must stop taking anti-inflammatory medicines (i.e. Advil®, ibuprofen, edtodolac, indomethacin, naproxen, Aleve®, Feldene®, diclofenac, Mobic®, and piroxicam). You do not need to stop taking Celebrex®. If you are unsure about any of your medicines, ask your doctor.
4. Call your local doctor if you take blood thinners such as heparin or Coumadin® (warfarin). Your INR will need to be less than 1.4 before your procedure if you take blood thinners.
5. You must be healthy on the day of your block. You must
- Be free of infection, not taking antibiotics.
- Not have cold or flu symptoms.
- Not have any rashes.
- Not have a fever greater than 100.4° F.
- No local infection or skin lesion on your neck.
6. If you are feeling sick or have a cold, call the team to let us know. Please try to call 24 hours or more in advance.
7. Call ((608) 265-1770 if you need to cancel or have any questions.
8. Do not eat for 6 hours or drink clear liquids for 3 hours before your procedure. You may take a sip of water if you need to take medicine.
9. Take your usual medicines on the day of the procedure unless told otherwise by your doctor.
10. Bring your pain medicines with you to the hospital. Make sure you have enough with you to take after the procedure. You may still need it. The doctor who does your injection will not give you a prescription for pain medicine to take home.
11. Bring your latest MRI or CT scans (films) if these were not done at UW Hospital or Research Park Clinic. If you do not bring these films with you, your procedure cannot be done. If you have had any spine surgery in the past, you need to bring an MRI or CT scan that was done after your surgery. If you are unsure where or when your MRI or CT scan was done, call your doctor.
12. Tell us if you have any drug allergies or if you have had a reaction to X-ray dyes (contrast dyes), iodine, Betadine, seafood, shellfish, latex, or numbing medicines.
13. Make sure someone is able to drive you home. You can not drive yourself home after the block.
During the Block Procedure
This test is done in a procedure room that has an X-ray machine. Before the test, you will change into a hospital gown and an IV will be started in your arm. If needed, a medicine to help you relax will be offered. It will be given through the IV. You will remain awake, but relaxed during the test.
You will lie on the X-ray table on your back. We will watch your blood pressure, heart rate, and oxygen levels. We will place a pillow under your neck to arch your neck backwards. Your neck will be cleaned and covered with a sterile drape. Using the X-ray machine, your doctor will guide a thin needle into the front of your neck. Your doctor will inject contrast dye through the needle to make sure it is in the right place. X-rays will be taken. Numbing medicine will be injected into the site. During the block, you will be asked to lie very still and not talk, swallow, or cough. The block takes about 30 minutes.
During and after the test, your doctor will check the temperature of your fingertips on both hands. This is done using small sensors on your finger. The sensors will stay on for about 30 minutes.
What to Expect after the Block
When the test is over, you will go to the recovery room for 30 to 60 minutes.
Your driver will take you home. Your local doctor may ask you go to physical therapy after the test.
For the first few hours, you can expect any of these to occur on the side of the body where the test was done.
- Watery, red eye
- Dilated pupil
- Droopy eyelid
- Droopy face
- Hoarse voice
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. 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. Complete this form. Make a copy for your records and mail it back to us in the prepaid envelope. We will need this information to decide if you will or will not benefit from similar injections in the future.
You may have changes in the feeling, color, or temperature of your arms for a few hours after the test. Please note any changes on the pain log. This information is very important to your doctor.
You should continue to take your routine medicines.
Contact your doctor’s office to schedule a follow-up visit. Your doctor will get a report of the block within one week.
If you have any problems, notice new symptoms or signs of infection, please call(608) 265-1770.
Signs of infection
- Fever greater than 100.4° F (by mouth) for 2 readings taken 4 hours apart
- Increased redness, swelling around the injection site
- Any drainage from the injection site
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 12/28/2011
Copyright © 12/28/2011 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#5953
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