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Sympathetic Nerve Block

Stellate Ganglion Lumbar Sympathetic Nerve Block

What is a sympathetic nerve block?

A  sympathetic nerve block can be used to diagnose and/or treat pain disorders involving the sympathetic nervous system. The injection consists of a local anesthetic.

The sympathetic nervous system is a network of nerves throughout your body. The nerves branch from your spine and control some body functions, such as the closing of blood vessels. A problem with these nerves can affect blood flow and cause symptoms in the hands or feet. They may hurt, burn, feel cold, or be tender to touch.

The sympathetic nervous system is controlled by bunches of nerves called ganglions. One large ganglion, called the stellate ganglion, helps control nerves in the upper body. In the lower body, nerves are controlled by several ganglions that make up the sympathetic chain.

Does the injection hurt?

The procedure is done with x-ray guidance and involves inserting a needle through skin and deeper tissues. There is some discomfort involved. However, the skin and deeper tissues are numbed with a local anesthetic. Most patients also receive intravenous sedation, which makes the procedure easy to tolerate.

Are there risks?

With any procedure, there are risks and the possibility of complications. Risks of this procedure include infection, bleeding, puncture of a blood vessel, or lung puncture (depending on area involved).    

Are there side effects?

You may experience a variety of symptoms following the procedure. The following symptoms are normal and should not cause alarm. Many of these will last only a few hours until the anesthetic wears off.

  • Discomfort at the injection site.
  • A feeling of warmth of the affected extremity.
  • Weakness or numbness in the affected extremity. Please use caution until weakness is resolved.
  • Neck injection - Eyelid on injection side may droop. Voice may be hoarse. May have difficulty swallowing.
  • Mid-back injection - May notice a color or temperature change or increased mobility in the extremity on the injection side.

Report the following problems:

  • Redness, swelling or drainage at the injection site.
  • Unusual pain that interferes with your usual activities of daily living.
  • Temperature of 101° F or greater.

How should I prepare for the procedure?

  • Bring a list of your current medications, allergies and surgeries with dates, if known.
  • If you are on any type of blood thinning medications; i.e., Coumadin, Heparin, Ticlid, Persantine, Pletal, Plavix, Lovenox, Trental Aggrenox, Agrylin, Aspirin, please notify your physician at least 2 weeks prior to your appointment.
  • Notify the Pain Management Center if you are pregnant or have an infection.
  • Bring a driver with you.
  • Take routine medications, including pain medicine. Do not take blood thinning medications.
  • You must not eat or drink 6 hours prior to your procedure, unless otherwise directed.
  • Wear loose fitting clothing (elastic waist is advisable).

What will happen the day of the procedure?

  • We will review your medical history.
  • We will start an IV.
  • We will monitor you during the procedure and for a minimum of 30 minutes afterward.
  • You will not be able to return to work that day. You are advised to go home and rest until the following day. It is advisable to have someone with you at home for the remainder of the day.
  • After the procedure, you may eat. You may resume normal medications, except for blood thinners. We will advise you when to restart blood thinners.

What should I do after the procedure?

  • Apply ice to the injection site during the first 24 hours after the procedure.
  • Leave bandages on until the next day, and do not shower or bathe until then.
  • If you receive IV sedation, do not drive, operate machinery, make critical decisions, or sign legal documents for 24 hours.