Stellate Ganglion Block

There are relatively few indications for cancer pain relief from stellate ganglion block. Cancer from head and neck and sympathetically mediated pain from the upper extremities are usually the main reasons for performing this block. The technique is the same as stellate ganglion block described elsewhere in the book, especially in relation to the management of the complex region pain syndrome (CRPS). Diagnostic block can be done by using 5 ml of bupivacaine 0.25-0.5%. Neurolytic block can be done using 6% phenol 3 ml and is used if diagnostic block is successful in controlling the pain on a temporary basis.

Complications

Common complications associated with neurolytic stellate ganglion block include prolonged Horner's syndrome, prolonged hoarseness of voice due to the effect on the recurrent pharyngeal nerve, permanent weakness or numbness of the upper extremity, possible injection of neurolytic medication in the epidural or intrathecal space which may cause permanent or temporary neurological deficits, and possible injection of neurolytic material in the vascular structures such as vertebral artery. Seizures or cerebral infarctions, sloughing of the skin or subcutaneous tissues and possible pneumothorax may occur.

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