Sympathetic Nerve Block
A sympathetic nerve block affects the sympathetic nerves, which control the involuntary functions in your body that you don't have to think about.
Sympathetic nerve block procedure
The location of your pain usually determines where you'll receive the nerve block. Your sympathetic nerves come together outside your spine area in thick networks of nerves called ganglions. If you have pain in the upper part of your body, you may get pain relief from blocking the stellate ganglion in your neck area. If you have pain in the lower part of your body, a ganglion near the lower spine may be targeted with a lumbar sympathetic block.
This is what may happen during a sympathetic block procedure:
You will meet with a pain management specialist experienced in conducting nerve blocks.
Your health care provider will ask about all the medicines you're taking, including vitamins and supplements, and whether you have any allergies.
You may be asked to fast for about 6 hours before the procedure.
The medical team may start an intravenous line and monitor your vital signs carefully.
You may be given some medicine through the IV line to make you relaxed and sleepy.
Before the actual block, the area in your neck or back will be made numb with a local anesthetic.
X-rays (or fluoroscopy) may be used to help the specialist find the right ganglion.
Once the ganglion is located, it is blocked by injecting it with an anesthetic solution, or sometimes other chemicals are used.
After nerve block treatment
A sympathetic nerve block is a relatively safe procedure. You can usually go home afterward and return to your normal activities after a day of rest. If you had IV sedation, you'll probably need to have someone drive you home.Side effects after a sympathetic block may include temporary soreness, a feeling of warmth, or some weakness. If you've received a nerve block in the stellate ganglion, you may experience some temporary voice changes, eyelid droop, or difficulty swallowing. Until swallowing is back to normal, avoid large bites of food and sip liquids carefully.Physical therapy, talk therapy, and pain medicine may all be part of your treatment along with sympathetic block. In most cases, you will be given a series of blocks to get the best possible response.Sympathetic blocks don't work for everyone. Also, the pain relief they give may lessen over time. But for some, a sympathetic block may provide weeks or months of pain relief.
Who performs a sympathetic nerve block? Anesthesiologists who specialize in pain medicine perform sympathetic nerve blocks. An anesthesiologist is a doctor who specializes in providing anesthesia and pain relief.
How is a sympathetic nerve block performed? Your sympathetic nerve block will be performed in a hospital or outpatient setting. The procedure takes about 30 minutes. You may need a series of procedures over several weeks for full pain relief.
A sympathetic nerve block generally includes these steps:
You will dress in a hospital gown. It is a good idea to leave all jewelry and valuables at home or with a family member. Your care team will give you blankets for modesty and warmth. You will talk with the anesthesiologist about your medical history and your sympathetic nerve block.
You will lie on a table and a team member will start an intravenous (IV) line.
You may have medication (a light sedative) through the IV to make you drowsy and relaxed.
A team member will clean the injection area.
Your anesthesiologist will inject a small amount of local anesthetic into your skin to numb the injection area. The location is either the lower (lumbar) back for lower body pain, or the back of the neck for upper body pain.
Your anesthesiologist will guide a needle into place near the affected nerves using X-ray guidance.
Your anesthesiologist will inject an anesthetic around the group of sympathetic nerves.
Your doctor will remove the needle and bandage the injection site.
The procedure team will monitor your vital signs and other critical body functions. This occurs throughout your procedure and recovery until you are alert, breathing effectively, and your vital signs are stable.