771 - Ultrasound-Guided Stellate Ganglion Block: Technique, Safety, and Expanding Clinical Applications

Learning Objectives: To provide a practical overview of the anatomy, technique, and clinical uses of ultrasound-guided stellate ganglion block (SGB), with a focus on its growing role in managing sympathetic nervous system-related conditions.

Background: Stellate ganglion block (SGB) is a procedure used to interrupt the sympathetic nervous system, often for conditions like complex regional pain syndrome (CRPS), hot flashes, refractory angina, and more recently, post-traumatic stress disorder (PTSD) and long COVID symptoms. SGB utilizes injections of local anesthetics, such as Bupivacaine or Ropivacaine, to reduce dampen nervous function to treat targeted symptoms. Traditionally performed using landmark-based or fluoroscopic techniques, SGB is now most commonly done under ultrasound guidance, which allows for real-time visualization of nearby structures and helps reduce the risk of complications. Due to its precision and safety, ultrasound-guided SGB has become an increasingly valuable tool for interventional radiologists.

Clinical Findings/Procedure Details: This exhibit walks through the ultrasound-guided SGB technique step by step—from patient positioning and probe placement to identifying key anatomy like the longus colli muscle, carotid and vertebral arteries, and surrounding fascia. We’ll share practical tips, pearls, and pitfalls based on real-world experience. We’ll also review current literature supporting its use in a variety of clinical scenarios, including chronic pain syndromes, PTSD, and autonomic dysfunction.

Conclusion and/or Teaching Points: Ultrasound-guided stellate ganglion block is a safe, minimally invasive procedure with a wide and expanding range of clinical applications. A strong understanding of both relevant anatomy and technique is necessary to perform the block safely. As interest in SGB continues to grow—especially in areas like neuropsychiatric and autonomic disorders—interventional radiologists have a real opportunity to advance the quality of patient care.

During the preparation of this work, the author(s) used Chat-GPT 5 in order to check grammar and reorganize certain structures for improved clarity.