The stellate ganglion is formed by the fusion of the 6th and 7th cervical ganglia and the first thoracic ganglion, located in front of the transverse process of the 7th cervical vertebra to the front of the 1st rib neck, above the long cervical muscle, which is surrounded by the pulmonary apex, common carotid artery, subclavian artery and vertebral artery. Once you see the anatomy of the stellate ganglion, you may be discouraged, wow, there are so many important organs around, if you accidentally hit the wrong place what to do?
In fact, for a trained pain physician, this treatment is just one of the routine operations that a resident must be skilled in, and the procedure is not complicated.
With a 5ml syringe, the needle is inserted vertically to reach the root of the cervical 6 transverse process, and 0.6% to 0.8% lidocaine 6-8ml is injected after aspiration without blood, cerebrospinal fluid, or gas, and the whole operation can be completed in less than 1 minute before and after.
So what diseases can stellate ganglion block (SGB) treat?
Studies have shown that repeated SGB is a resurrection exercise for the vegetative nerves and can restore the disruption of sympathetic vagal balance due to increased sympathetic activity. Blood norepinephrine (NE) is a sensitive indicator of sympathetic activity.
It was found that NE in serum decreased significantly after SGB in patients with pain, cancer, and menopausal syndrome, but it was still within the normal range; while NE concentration in plasma was changed after SGB in normal subjects, but the difference was not significant.
At the same time, SGB can improve blood supply to tissues and organs, and improve abnormal blood rheological indicators, including reducing whole blood hyperviscosity and erythrocyte pressure volume to accelerate blood circulation.
Furthermore, SGB increases cerebral blood flow more than any drug, and the increase in hypothalamic blood flow can play a role in maintaining pituitary hormone homeostasis, thus regulating the abnormal changes in the endocrine system.
In addition, it has been reported in the literature that the cellular and humoral immune functions of patients with chronic diseases are improved after SGB.
The regulation of homeostatic function in the body by SGB has been shown to be beneficial in patients with facial nerve palsy, headache, herpes zoster, and reflex sympathetic dystrophy when long-term, multiple SGB treatments are administered, and the original accompanying diseases can be converted to favorable aspects, and some can return to normal.
For example, the blood graves of patients with hypertension and hypotension can return to normal. And it does not cause overkill.