Stellate Ganglion Block (SGB) Risks, Dr. James Lynch

Risks of a stellate ganglion block procedure are described here by Dr. James Lynch of Gambrills, Maryland. The stellate ganglion lies along a nerve called the Cervical Sympathetic Trunk which is located on both sides of the neck just next to your windpipe (trachea). A stellate ganglion “block” is simply an injection of local anesthetic along this nerve to put it to sleep for a few hours. A high level of skill is critical when injecting in the neck since there are many important structures adjacent to the stellate ganglion. Many doctors were trained to use fluoroscopy (live x-ray) to perform SGB; however, Dr. Lynch uses ultrasound. Ultrasound-guided SGB is safer, more effective, and does not expose patients to ionizing radiation like fluoroscopy does. Most importantly, though, ultrasound provides incredible visibility of your anatomy, including blood vessels and any anatomic variations, which may go unnoticed with fluoroscopy. In contrast, under x-ray (fluoroscopic) guidance, only bones are visible, and since blood vessels and nerves are not visible, the position of the nerves can only be approximated. Blood vessels may be inadvertently punctured using fluoroscopy, but they are clearly visible in color under ultrasound. Using ultrasound guidance to safely perform an SGB takes additional advanced ultrasound training and considerable skill which many pain medicine-trained physicians do not have.