777 - Stellate Ganglion Block: A Primer

Learning Objectives:

1. Review the indications for stellate ganglion block, including for malignancy related pain and PTSD


2. Review relevant anatomy related to the stellate ganglion nerve block


3. Review efficacy and safety profile of the stellate ganglion nerve block


4. Present an algorithm for stellate ganglion nerve block, including relevant medications, dosages, technique and follow-up

Background: The stellate ganglion is a star-shaped ganglion typically located anterior to the neck of the first rib, typically located on the anterior surface of the longus colli muscle near the common carotid artery and jugular vein {1}. It provides sympathetic innervation to portions of the head, neck and upper limbs and can be a key target for any intervention targeting at providing pain relief in these areas {2}. In addition to the indication for pain, there has been recent evidence suggesting the efficacy of stellate ganglion block (CPT 64510) for the treatment of posttraumatic stress disorder symptoms in veterans, suggesting a unique benefit to the block beyond the typical pain control offered by most other nerve block interventions {3}.

Clinical Findings/Procedure Details: This exhibit will first review the anatomy of the stellate ganglion and provide ultrasound and CT landmarks relevant to the block. Next, indications for the stellate ganglion block will be provided along with a review of the relevant literature as it relates to the safety and available efficacy data for different interventions. Finally, this exhibit will discuss the technical details for performing a stellate ganglion block, including medications to administer, dosage of medications, key landmarks, and expected imaging findings.

Conclusion and/or Teaching Points: Stellate ganglion block has applications beyond the typical pain control afforded by other nerve blocks. This exhibit aims to provide a comprehensive review of the technical aspects of the block, indications, safety and efficacy.