A sympathetic nerve block is an injection of an anesthetic near the affected sympathetic nerves to block pain. It is performed to determine if damage to the sympathetic nerves is the cause of the patient’s pain. If the block provides temporary pain relief, your physician may recommend a series of blocks to provide longer pain relief.
Sympathetic nerves originate from the front of the spine and are part of the autonomous nervous system that controls several involuntary body functions including blood pressure, heart rate and digestion, and sweating. Sometime the nerves can continue to transmit pain even after an injury is healed.
A sympathetic nerve block may be recommended for the following:
You will be taken to the pre op area where trained nursing staff will get you ready for the procedure by taking vitals and reviewing your medications. Your blood sugar and coagulation status may also be checked if needed.
Then you will enter the procedure room where you will lie, usually, face down on a table. For the stellate ganglion block in the neck, you will lie on your back.
The injection site is then cleansed and injection of a local numbing agent is given in the area so that you don’t feel pain during the procedure.
The location of the injection will depend on which sympathetic nerves are being blocked. To block pain in the upper part of the body a stellate ganglion nerve block is given in the neck, for abdominal pain the block is given in the celiac plexus, for pelvic pain the hypogastric plexus is blocked and for pain in the lower back a lumbar sympathetic block is administered.
A thin hollow needle is then inserted around the nerves to be blocked or numbed. The doctor is guided by fluoroscopic X-ray to place the needle in the correct position. This system gives real time X-ray images of the position of the needle in the spine on a monitor for the physician to view.
A contrast material is then injected through the hollow needle to confirm that the drug flows to the affected nerve when injected.
When the doctor is satisfied with the position of the needle, the anesthetic drug is injected through the same needle.
The needle is then removed and the injection site is covered with a dry, sterile bandage.
You may feel some pressure during the injection but mostly the procedure is not painful and usually takes about 15-20 minutes to complete.
The sympathetic nerve block procedure is generally safe. With the use of live imaging though X-ray machines, contrast dye, and physicians trained in the latest interventional techniques, complications are rare. But with all medical procedures, complications can occur. These may include: