SG: Sympathetic ganglion is located on either side of root of neck, and it is fusion of inferior cervical ganglion with 1st (and sometimes also 2nd) thoracic ganglion
Anterior structures to SG
Subcutaneous tissue
Sternocleidomastoid muscle
Subclavian artery
Carotid sheath
Posterior structures to SG
Anterior scalene muscle
Brachial plexus
Neck of 1st rib
C7 transverse process
Vertebral artery
Longus colli muscle
Medial structures to SG
Prevertebral fascia
C7 vertebral body
Esophagus
Thoracic duct
Lateral structures to SG
Superior intercostal vein
Superior intercostal artery
Ventral ramus of 1st thoracic nerve
Inferior structures to SG
Pleura over apex of lungs
SGB: Neural blockade of sympathetic chain at cervical level resulting in sympathectomy of upper extremity of ipsilateral targeted chain
Produces analgesia for sympathetic mediated pain with resultant vasodilation
PREPROCEDURE
Indications
Contraindications
Getting Started
PROCEDURE
Patient Position/Location
Equipment Preparation
Procedure Steps
POST PROCEDURE
Expected Outcome
Things To Do
Things To Avoid
OUTCOMES
Complications
Selected References
Anciaux DJ et al: Stellate ganglion blockade for management of electrical storm post myocardial infarction. J Clin Anesth. 58:72, 2019
Goel V et al: Complications associated with stellate ganglion nerve block: a systematic review. Reg Anesth Pain Med. ePub, 2019
Mehrotra M et al: Neuroanatomy, Stellate Ganglion 2019
Piraccini E et al: Stellate Ganglion Blocks 2019
Chang KV et al: Ultrasound-guided interventions of the cervical spine and nerves. Phys Med Rehabil Clin N Am. 29(1):93-103, 2018
Rahimi M et al: The effect of stellate ganglion block on the function of arteriovenous fistulas for hemodialysis: a randomized trial. J Vasc Access. 1129729818809907, 2018
Sekhri NK et al: Radiofrequency ablation of the stellate ganglion for management of acute digital ischemia: a case report. A A Pract. 11(7):189-92, 2018
Wang D: Image guidance technologies for interventional pain procedures: ultrasound, fluoroscopy, and CT. Curr Pain Headache Rep. 22(1):6, 2018
Birklein F et al: Complex regional pain syndrome-up-to-date. Pain Rep. 2(6):e624, 2017
Fudim M et al: Stellate ganglion blockade for the treatment of refractory ventricular arrhythmias: a systematic review and meta-analysis. J Cardiovasc Electrophysiol. 28(12):1460-7, 2017
Chang KV et al: Sonographic nerve tracking in the cervical region: a pictorial essay and video demonstration. Am J Phys Med Rehabil. 95(11):862-70, 2016
Imani F et al: Effectiveness of stellate ganglion block under fuoroscopy or ultrasound guidance in upper extremity CRPS. J Clin Diagn Res. 10(1):UC09-12, 2016
Duggappa DR et al: Anaesthesia for patient with chronic obstructive pulmonary disease. Indian J Anaesth. 59(9):574-83, 2015
Wei K et al: Ultrasound-guided stellate ganglion blocks combined with pharmacological and occupational therapy in complex regional pain syndrome (CRPS): a pilot case series ad interim. Pain Med. 15(12):2120-7, 2014
Bhatia A et al: Evaluation of sonoanatomy relevant to performing stellate ganglion blocks using anterior and lateral simulated approaches: an observational study. Can J Anaesth. 59(11):1040-7, 2012
Feigl GC et al: Comparison of different injectate volumes for stellate ganglion block: an anatomic and radiologic study. Reg Anesth Pain Med. 32(3):203-8, 2007
Kakazu CZ et al: Stellate ganglion blockade for acute postoperative upper extremity pain. Anesthesiology. 102(6):1288-9; author reply 1289, 2005
Long TR et al: Perioperative interscalene blockade: an overview of its history and current clinical use. J Clin Anesth. 14(7):546-56, 2002
Fields H et al: Peripheral neuropathic pain: an approach to management. In: Wall PD et al: Textbook of Pain. London: Churchill Livingstone. 1523–9, 1999
Christie JM et al: Computerized axial tomography to define the distribution of solution after stellate ganglion nerve block. J Clin Anesth. 7(4):306-11, 1995
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
Preprocedure
Procedure
Outcomes
TERMINOLOGY
Abbreviations
Stellate ganglion (SG)
SG block (SGB)
Definitions
SG: Sympathetic ganglion is located on either side of root of neck, and it is fusion of inferior cervical ganglion with 1st (and sometimes also 2nd) thoracic ganglion
Anterior structures to SG
Subcutaneous tissue
Sternocleidomastoid muscle
Subclavian artery
Carotid sheath
Posterior structures to SG
Anterior scalene muscle
Brachial plexus
Neck of 1st rib
C7 transverse process
Vertebral artery
Longus colli muscle
Medial structures to SG
Prevertebral fascia
C7 vertebral body
Esophagus
Thoracic duct
Lateral structures to SG
Superior intercostal vein
Superior intercostal artery
Ventral ramus of 1st thoracic nerve
Inferior structures to SG
Pleura over apex of lungs
SGB: Neural blockade of sympathetic chain at cervical level resulting in sympathectomy of upper extremity of ipsilateral targeted chain
Produces analgesia for sympathetic mediated pain with resultant vasodilation
PREPROCEDURE
Indications
Contraindications
Getting Started
PROCEDURE
Patient Position/Location
Equipment Preparation
Procedure Steps
POST PROCEDURE
Expected Outcome
Things To Do
Things To Avoid
OUTCOMES
Complications
Selected References
Anciaux DJ et al: Stellate ganglion blockade for management of electrical storm post myocardial infarction. J Clin Anesth. 58:72, 2019
Goel V et al: Complications associated with stellate ganglion nerve block: a systematic review. Reg Anesth Pain Med. ePub, 2019
Mehrotra M et al: Neuroanatomy, Stellate Ganglion 2019
Piraccini E et al: Stellate Ganglion Blocks 2019
Chang KV et al: Ultrasound-guided interventions of the cervical spine and nerves. Phys Med Rehabil Clin N Am. 29(1):93-103, 2018
Rahimi M et al: The effect of stellate ganglion block on the function of arteriovenous fistulas for hemodialysis: a randomized trial. J Vasc Access. 1129729818809907, 2018
Sekhri NK et al: Radiofrequency ablation of the stellate ganglion for management of acute digital ischemia: a case report. A A Pract. 11(7):189-92, 2018
Wang D: Image guidance technologies for interventional pain procedures: ultrasound, fluoroscopy, and CT. Curr Pain Headache Rep. 22(1):6, 2018
Birklein F et al: Complex regional pain syndrome-up-to-date. Pain Rep. 2(6):e624, 2017
Fudim M et al: Stellate ganglion blockade for the treatment of refractory ventricular arrhythmias: a systematic review and meta-analysis. J Cardiovasc Electrophysiol. 28(12):1460-7, 2017
Chang KV et al: Sonographic nerve tracking in the cervical region: a pictorial essay and video demonstration. Am J Phys Med Rehabil. 95(11):862-70, 2016
Imani F et al: Effectiveness of stellate ganglion block under fuoroscopy or ultrasound guidance in upper extremity CRPS. J Clin Diagn Res. 10(1):UC09-12, 2016
Duggappa DR et al: Anaesthesia for patient with chronic obstructive pulmonary disease. Indian J Anaesth. 59(9):574-83, 2015
Wei K et al: Ultrasound-guided stellate ganglion blocks combined with pharmacological and occupational therapy in complex regional pain syndrome (CRPS): a pilot case series ad interim. Pain Med. 15(12):2120-7, 2014
Bhatia A et al: Evaluation of sonoanatomy relevant to performing stellate ganglion blocks using anterior and lateral simulated approaches: an observational study. Can J Anaesth. 59(11):1040-7, 2012
Feigl GC et al: Comparison of different injectate volumes for stellate ganglion block: an anatomic and radiologic study. Reg Anesth Pain Med. 32(3):203-8, 2007
Kakazu CZ et al: Stellate ganglion blockade for acute postoperative upper extremity pain. Anesthesiology. 102(6):1288-9; author reply 1289, 2005
Long TR et al: Perioperative interscalene blockade: an overview of its history and current clinical use. J Clin Anesth. 14(7):546-56, 2002
Fields H et al: Peripheral neuropathic pain: an approach to management. In: Wall PD et al: Textbook of Pain. London: Churchill Livingstone. 1523–9, 1999
Christie JM et al: Computerized axial tomography to define the distribution of solution after stellate ganglion nerve block. J Clin Anesth. 7(4):306-11, 1995
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