What Is a Stellate Ganglion Block?

The stellate ganglia is one of the cervical sympathetic ganglia. It consists of the fusion of the inferior cervical ganglion and the first thoracic sympathetic ganglion. The sympathetic nerve fibers emitted from the lateral horns of the spinal gray matter from the 8th to the 1st thorax of the stellate ganglion dominate the eyelid muscles, pupillary muscles, capillary smooth muscles, and sweat glands. Sympathetic nerve fibers from the stellate ganglion also participate in the formation of the cardiac plexus and participate in the regulation of heart and blood vessel activity.

Basic Information

Chinese scientific name

Stellate ganglia

nickname

Cervical thoracic ganglion

Distribution location

Vertebral artery triangle

Types of

Sympathetic nerve

Sympathetic Nerve Sympathetic Nerve Anatomy

The preganglionic fibers of the cervical sympathetic nerve come from the white communication branch of the upper thoracic spinal nerve. After alternating neurons in the cervical sympathetic ganglia, the postganglionic fibers are connected to the cervical spine nerves and coincide with each other, and some are still connected to the cerebral nerves. . Its distribution range is very wide, it can control the sweat glands and blood vessels of the face with the external carotid artery; inner sweat artery of the brain, fundus, pupil, eyelid smooth muscle and skin near the eyebrow arch through the internal carotid artery; innervate the brain stem, cerebellum, brain with the vertebral artery Blood vessels in the temporal lobe, occipital lobe, and inner ear. The three ganglia of the neck still send out post-ganglia fibers to form the heart branch to control the heart rhythm.

Stellate ganglion block

(A), a kind of nerve block. The stellate ganglion is a fusion of the inferior cervical sympathetic ganglion and the first thorax sympathetic ganglion, which dominates the head, neck, and upper limb sympathetic nerves, and is located behind the seventh cervical transverse process and the first rib neck behind the subclavian artery. During the operation, the needle can be vertically advanced next to the horizontal cartilage of the circular cartilage to touch the sixth cervical transverse process, and the needle can be retracted to the skin and the needle can be tilted down 45 °. The needle can be punctured to the seventh cervical transverse process. , For the treatment of vascular neuropathic or ischemic headache, upper limb trauma, vascular spasm, edema and vasculitis caused by surgery, ischemia and pain.

Stellate ganglion block (stellateganglionblock): Stellate ganglion block has a significant effect on vertebral artery type cervical spondylosis and sympathetic cervical spondylosis. The stellate ganglion is the main sympathetic ganglion that dominates the head, neck, shoulders and upper limbs. After the stellate ganglion block, it eliminates the excessive tension of the sympathetic ganglion and dilates the blood vessels in its dominating area. Increased arterial blood flow velocity and blood flow improves the blood supply to the head and neck and improves symptoms.

(1) Anatomy: The cervical sympathetic ganglion is located behind the carotid sheath and anterior to the cervical transverse process. Generally there are 3 sympathetic ganglia on each side, which are called superior cervical ganglia, central cervical ganglia, and inferior cervical ganglia. The inferior cervical ganglion is located in front of the transverse process of the seventh cervical vertebra and behind the beginning of the vertebral artery. It is often merged with the first thoracic sympathetic nerve in a star shape, also known as the stellate ganglion or cervical thorax. The stellate ganglion is located at the base of the transverse process of the 7th cervical vertebra and in front of the 1st rib neck, inside the oblique muscle, above the apex of the lung, and adjacent to the apex of the lung, oblique muscle, subclavian artery, common carotid artery, and vertebral artery.

(2) Operation: The patient lies on his back with a thin pillow under the pillow, flexes the neck slightly to retract the mandible, and relaxes the anterior cervical muscles. The index finger of the left hand or middle finger is close to the upper edge of the sternoclavicular joint, and it is pulled down slightly along the side wall of the trachea to pull the sternocleidomastoid muscle and its deep common carotid artery sheath to the outside. Press down with your fingertips, you can touch the transverse process of the seventh cervical vertebra, your fingers are fixed, your right hand is holding the syringe with the needle behind the No. 5 ball, and insert the needle vertically along the nail of your left index finger or middle finger. Suddenly. Slightly withdraw the needle and suck back bloodless and cerebrospinal fluid, and inject 5-10 ml of analgesic solution.