In recent years, many studies have been conducted on the mechanism of action of stellate ganglion block. The results of these studies have shown that the action of stellate ganglion block involves the vegetative nervous system, endocrine system and immune system, and has a regulatory effect on the function of the above systems. The block helps to maintain the stability of the body’s internal environment and allows the correction of many phytonadic disorders. 1. Anatomy and physiology of the cervical sympathetic ganglion is located in the posterior part of the cervical vascular sheath, and there are generally three sympathetic ganglia on each side of the transverse process of the cervical spine called the superior cervical ganglion, the middle cervical ganglion, and the inferior cervical ganglion, respectively. The inferior cervical ganglion, which also becomes the stellate or cervicothoracic ganglion, is irregular in shape, larger than the middle cervical ganglion, and is located anteriorly between the base of the transverse process of the seventh cervical vertebra and the neck of the first rib, posterior to the vertebral artery, medial to the oblique muscle group, and with the pulmonary apex below it. The inferior border of the stellate ganglion is located at the posterior aspect of the pleura and is covered by loose cellular and adipose tissue. (1) Anterolateral approach puncture method (paratracheal approach method) The patient is placed supine with a pillow under the shoulder. The operator is positioned on the left side and first uses the index and middle fingers of the left hand to push the common carotid artery and sternocleidomastoid muscle to the lateral side. In general, patients with the tip of the index finger can touch the transverse process of the seventh cervical vertebra, and the needle is guided to penetrate about 2-3 cm and touch the bone, indicating that the tip of the needle has reached the anterolateral aspect of the transverse process of the seventh cervical vertebra, and the needle is withdrawn a little (0.2-0.4 mm), and no blood is sucked back. It should be noted that there is no foreign sensation when puncturing the stellate ganglion, so it is not necessary to look for foreign sensation. (2) High lateral puncture method The patient lies supine with the head turned to the opposite side and the skin is routinely disinfected. The operator takes the puncture point on the left side at the intersection of the posterior border of the sternocleidomastoid muscle and the external jugular vein, which is equivalent to the level of the cricoid cartilage or the transverse process of the sixth cervical vertebra. The cerebrospinal fluid can be injected as a local drug. The indications for stellate ganglion are very broad and can be classified by site as follows: (1) systemic diseases of vegetative nerve dysfunction, primary hypertension, primary hypotension, hyperthyroidism, hypothyroidism, anorexia, anorexia nervosa, postural blood pressure abnormalities, insomnia, generalized hyperhidrosis, vertigo, generalized lichen planus, itchy skin, seborrheic dermatitis, post-stroke pain, multiple sclerosis, myasthenia gravis, herpes zoster, herpes simplex, infectious mononucleosis, chronic fatigue syndrome, reflex sympathetic dystrophy, phantom limb pain, amputation pain, diabetes mellitus. (2) Head disorders such as demodicosis, headache (including migraine, tension headache, cluster headache, temporal arteritis headache), cerebral thrombosis, cerebral vascular spasm, cerebral infarction, etc. (3) Facial disorders such as peripheral facial nerve palsy, atypical facial pain, masticatory muscle syndrome, and mandibular joint syndrome. (4) Eye diseases such as retinal vascular occlusion, retinitis pigmentosa, uveitis, optic neuritis, cystoid macular swelling, corneal ulcer, cataract, pupillary strain, mosquito flying, visual fatigue, refractive abnormalities. (5) Ear, nose and throat diseases chronic paranasal sinusitis, acute paranasal sinusitis, allergic rhinitis, sudden hard of hearing, exudative otitis media, Meniere’s disease, benign episodes of vertigo, nasal congestion, tonsillitis, tinnitus, pharyngeal sensory abnormalities, olfactory disorders. (6) Oral disorders such as post-extraction pain, tongue pain, endostomatitis, tongue inflammation, labyrinthitis, and dryness of the intraoral mucosa. (7) Neck and shoulder and upper limb disorders upper limb blood circulation disorders (such as Raynaud’s disease, Raynaud’s syndrome, acute arterial occlusive disease, neck-shoulder-arm syndrome, traumatic neck syndrome, thoracic outlet syndrome, shoulder periarthritis, postoperative swelling, post-mastectomy syndrome) tennis elbow, tenosynovitis, cervical spondylosis, arthritis, palmar hyperhidrosis, frostbite, frostbite, perineuritis, longitudinal nail fracture, axillary odor. (8) Circulatory system diseases myocardial infarction, angina pectoris, sinus tachycardia, cardiac neurosis. (9) Respiratory system diseases chronic bronchitis, pulmonary embolism, pulmonary edema, hyperventilation syndrome, bronchial asthma. (10) Digestive system diseases allergic enteritis, ulcerative colitis, gastritis, gastric ulcer, Crohn’s disease, peptic ulcer, constipation, diarrhea, hemorrhoids, etc. (11) Obstetrical and gynecological diseases abnormal menstruation, premenstrual tension, menstrual difficulties, menopause syndrome, post-hysterectomy phytonadic disorder, female infertility. (12) Urological disorders: neurogenic dysuria, nocturia, urinary incontinence, pyelonephritis, IgA nephropathy, wandering kidney, prostatitis, male infertility. (13) Low back and lower limb disorders, lumbago, knee pain, tinea pedis, erythema extremities, corns, frostbite and frostbite. Complications of stellate ganglion block include those related to local medication and those related to operation. (1) Complications related to local drug medication Drug injection into the blood vessels can cause local drug medication reactions; a few reactions sensitive to local drug medication; there are still hormones or other drugs added to the local drug medication. Injury to the stellate ganglion may be caused after multiple injections. Further studies and evaluations are needed. (2) Complications related to the manipulation technique The puncture needle injures the cervical vessels and causes local hematoma; the puncture needle should be withdrawn and pressure applied to stop the bleeding when there is re-blooding by suction. Puncture of the subarachnoid space by the puncture needle or even injection of drugs is an extremely serious complication. Inappropriate puncture angle or too low puncture site can lead to pneumothorax or hemopneumothorax. Inadequate aseptic operation can cause infection resulting in deep abscess. 5. Precautions Those with bleeding tendency should use stellate ganglion block with caution. The tissue should be observed for 10-15 minutes after the block, and those without adverse reactions should be allowed to leave the hospital. Be careful not to block bilateral stellate ganglia at the same time to prevent cardiopulmonary accidents.