Treatments & Therapies

Stellate Blockage – Treatment, Effects & Risks


The stellate blockade is a locally applied block anesthesia in the area of ​​the stellate ganglion to relieve vascular spasms in the form of arteriovenous cramps.

The affected blood vessels are sympathetically innervated and vasodilatation occurs within the entire area. This means that the blood vessels dilate, relax, there is a reduction in sweat secretion and if the treatment is successful, the so-called Horner syndrome appears .

What is stellate blockage?

The Ganglion Stellatum (from the Latin stellatum = star-shaped) is a star-shaped nerve cord in the neck. This ganglion regulates the autonomic nervous system .

In the stellate blockade, an anesthetic is injected into this nerve cord with the aim of relieving the patient in pain as much as possible. Ganglionic opioid analgesia is also possible at the same site. This enables both short-term and long-term pain relief.

Function, effect & goals

The stellate blockade can be used for a number of diseases and injuries that are associated with severe pain in the head and neck area. These include migraines , unilateral headaches , whiplash , craniocerebral trauma , trigeminal neuralgia or facial erythema caused by herpes zoster , which can also be associated with prolonged severe pain in some patients.

Other areas of application are the periarthritis of the shoulder joint known as “Frozen Shoulder” , osteochondrosis of the cervical spine and Raynaud’s disease . The stellate blockade can also help with the phantom pain that often occurs after amputations . Since the stellate ganglion is a nerve knot from which nerve strands radiate in a star shape, the blockade is also used to diagnose unclear pain conditions.

Pain usually occurs with tissue damage or with a wide variety of diseases. Sometimes, however, no cause can be identified. The pain can vary in intensity from mild to severe or unbearable, anything is possible. The quality of the pain can be described as stabbing or dull, and chronic pain syndrome sometimes develops . In modern medicine, one relies on good pain therapy , through medication, acupuncture , autogenic training and psychotherapy or physiotherapy. Sometimes psychotherapy and medication are used together. Only if none of this helps, after a whole series of examinations, is the stellate blockade used.

On the day of the treatment, the patients should only have eaten small and light meals and, if possible, only tea or water up to six hours before the stellate blockade. After that, eating, drinking and smoking are forbidden for medical reasons, because otherwise complications and interactions with the medication used can increase. In addition, no more cosmetics should be used if possible. All piercings, contact lenses and removable dentures must be removed beforehand.

In most cases, several individual sessions are necessary for optimal results. If possible, these are carried out on an outpatient basis. First of all, a venous access is placed in the patient in order to be able to administer medication in the event of allergic or other negative reactions in the body. An anesthetic is then injected into the front of the neck near the nerve node. This is usually no more painful than any normal puncture through a medical needle.

If ganglionic opioid analgesia is performed, an opioid is also injected . However, this can be injected as the sole painkiller. After the treatment, there is a warming on the side of the injection in the area of ​​the shoulder and arm and half of the face. Sometimes the injected pain reliever also causes swelling of the lining of the nose , as well as a constricted pupil and a drooping eyelid . The intervention can be done by ultrasound or X- raybe accompanied to check that the right area is hit. The full anesthetic takes effect after about a quarter of an hour and lasts for a few hours. Electrostimulation can be performed simultaneously during the session .

Risks, side effects & dangers

Of course, the stellate blockage also involves certain risks, like any other surgical procedure. Allergic reactions of all degrees of severity up to and including anaphylactic shock , bruising and bleeding or secondary bleeding can occur most frequently.

Inflammation or abscesses due to encapsulated foci of inflammation occur less frequently. Dead tissue and nerve irritation cannot be completely ruled out, but they are very rare, as are subsequent infections or sepsis (blood poisoning). Accidental damage to a nerve can result in paralysis or loss of sensation . If an artery is accidentally hit, the effect may be increased or cause further complications. An extremely rare puncture of the lungs can impede breathing by causing air to collect between the chest wall and the lungs.

Just as rarely, the effect can penetrate to the spinal cord . Sometimes there is a feeling of tightness in the throat, hoarseness , or nausea and vomiting . The side effects of opioids can include fatigue , itchy skin, urinary retention, or constipation . These are some of the main risks, but only the attending physician can provide precise advice.

Patients should not drive or use machines for at least 24 hours after an outpatient stellate blockade. You should have someone pick you up and if possible not be alone at first. The intake of any medicine must be discussed with the doctor beforehand in order to avoid dangerous interactions. In case of complications, a doctor should be consulted immediately.

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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.