Download Stellate ganglion nerve block GHPI0739_02_15_A4

Page 1 of 4
Patient
Information
Stellate Ganglion Nerve Block
Introduction
This leaflet provides information about the stellate ganglion
block, possible benefits and side effects, and what you should
do afterwards.
What is stellate ganglion block?
The proposed procedure is called a stellate ganglion block. It
involves an injection containing local anaesthetic with or without
a steroid on to the stellate ganglion. The stellate ganglion is a
collection of nerves which can be found either side of the
Adams apple in the neck. This part of the nervous system can,
in certain circumstances, cause pain in the arms and face, as
well as other symptoms such as swelling and colour and
sweating changes.
The Consultant feels that by injecting on to stellate ganglion,
you may have some relief from the symptoms you are
experiencing.
Where is it done?
The procedure will carried out either in the Chedworth Suite at
Cheltenham General Hospital, or the Orchard Day Centre at
Gloucester Royal Hospital. A letter with the appointment details
will be sent to you by the pain clinic secretaries.
How is it done?
Reference No.
GHPI0739_02_15
Department
Pain Clinic
Review due
February 2018
• You will be asked to wear a hospital gown
• Your blood pressure will be taken and recorded. A small
needle is put into the back of your hand as a safety
precaution in case you need medication
• You will be asked to lie flat on your back on the examination
table
• X ray pictures may be taken throughout the procedure to
help the Consultant direct the needle on to the stellate
ganglion
• The area to be injected is cleaned with antiseptic
www.gloshospitals.nhs.uk
Page 2 of 4
Patient
Information
• The Consultant will numb the area with local anaesthetic
before putting in the injection containing the local
anaesthetic and possibly a steroid on to the stellate ganglion
• It is important that you remain very still during the procedure
• Sedation is not usually required for this procedure. If you are
very anxious you may discuss this with the Consultant prior
to the procedure.
How long will I be in hospital?
Although the procedure itself takes 15 to 20 minutes, you will
be given a time to come in for either a morning or afternoon
procedure. Due to the way the theatre lists are organised, you
may have a substantial wait before your injections are done, so
please come prepared for this. After the procedure, you will be
offered a drink and a biscuit and allowed home shortly
afterwards.
Can I take my usual tablets?
Patients taking warfarin or other anticoagulants (blood thinning
medications), or diabetics taking medication, will be given
individual information. Please telephone the pain clinic nurse for
advice if this applies to you. All other medications should be
taken as normal.
Can I eat and drink?
Please do not have any food 6 hours prior to your appointment
time. You may have clear fluids up to 2 hours before your
appointment.
For example: If you have a morning appointment at 10.30am,
do not have any food after 4.30am.
Drink clear fluids (water, black tea or coffee) up until 8.30am.
Nothing to eat or drink after 6.30am.
Can I drive home?
For safety reasons you are asked not to drive on the day of
your procedure and that you have someone to pick you up. You
may also need someone with you for the rest of the day if you
are feeling unwell.
www.gloshospitals.nhs.uk
Page 3 of 4
What can go wrong?
Patient
Information
• Your blood pressure may fall during or immediately after the
procedure; this is monitored and can be appropriately
treated at the time by the Consultant
• Very rarely the needle may cause a leak of air from the top
of the lung (a pneumothorax); this can be dealt with
appropriately by the Consultant at the time
• Very rarely some of the drug used may be injected into the
small blood vessel near the ganglion. This may cause a brief
loss of consciousness, this can be dealt with appropriately
by the Consultant at the time
• Very rarely some temporary weakness of the arms may
occur. This could last for a few hours but you will recover
fully
• The area to be injected has some large blood vessels
nearby so there is a risk of some bruising
• In a small number of cases the nerve of the voice box may
be affected. This causes hoarseness of the voice, or
problems swallowing. These should both resolve within a
few hours. If you have problems swallowing you will be
required to remain in hospital until this is resolved
• You may experience a drooping on the eye lid (Horner’s
syndrome), which should resolve within a few hours
• It is normal to have some discomfort at the entry site of the
injection for a couple of days. However if the pain is severe
or you feel unwell you should contact your own doctor (GP)
or the Out of Hours service.
Will it work?
Stellate ganglion injections can be extremely effective but do
not work for everyone. There are some risks associated with
the procedure but it is worth trying. The benefits may be long or
short term. The important thing is to continue and increase
simple exercises. For example:
• Take the stairs instead of using the lift
• Increase your general activity a little each day
• Use the affected limb as much as possible.
www.gloshospitals.nhs.uk
Page 4 of 4
What happens next?
Patient
Information
About 6 weeks after your procedure you will either be asked to
telephone our Clinical Nurse Specialists to give a progress
report, or your Pain Consultant will give you a form to post back
to us. Either way, the next step in your treatment will be
decided according to the amount of benefit you have had from
the injections and any further appointments will be sent to you
in the post. If you are free from pain, you may not be routinely
followed up, but may be left with a 6 month open appointment
instead.
Contact information
Pain Clinic
Tel: 0300 422 2976
Monday/Wednesday/Friday, 9:00am to 12:00pm
Tuesday, 1.30pm to 4.00pm
An answering machine will be in operation at all other times.
For urgent calls please contact your GP or the Out of Hours
service.
Website: http://www.gloshospitals.nhs.uk/en/Wards-andDepartments/Departments/Pain-Management/Chroniclongterm-Pain-Service/
www.gloshospitals.nhs.uk