My wife has oralfacial pain which originated from nerve damage due to
a root canal. She has been treated to date with various drugs; Pamelor,
Elavil, Neurontin, Baclofen, etc. The drugs have been helpful but there is still
pain that varies in intensity from moderate to severe. The DMD who
is treating her wants to perform a Stellate Ganglion Block. We understand
that this can be diagnostic (she has had MRI's, Cat Scans, etc - all
negative) and possibly therapeutic? I would like to know your thoughts
on this, and what are the possible risks/side effects of this procedure? Thank you.
Stellate ganglion block involves the injection of local anesthetic agents into the region of the stellate ganglia (found in the neck area) for control of pain. The stellate ganglia is conposed of fibers from the sympathetic nervous system (part of the autonomic nervous system) including the inferior cervical sympathetic ganglia and the lower thoracic ganglia. Neurologist are not involved in doing sympathetic blocks and hence the specific side affects and colpications need to come from who is doing the procedure. Since the sympathetic nervous system is involved in autonomic function you can have chabges in heart rate or cardiac QT intervals, changes in pupil response (usually small pupils) and changes in sweating and blood flow. The presence of a Horners syndrome (small pupil, droopy eye and loss of sweating)usually signifies a sympathetic block at the stellate ganglia. The degree of pain relief varies considerably and would determine if a surgical procedure should be initiated. You need to speak directly to the person who is doing the procedure and ask how many cases they have done and what the outcome and complications have been. This can be a very good treatment both diagnostic and therapeutic for the right patient. Good luck.
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