Several aspects of stellate ganglion block


  • E. P. Yevstratov Odrex Medical House, Odessa
  • N. V. Krupskaya Odessa Regional Clinical Hospital
  • V. Y. Shumlyanskiy Odessa National Medical University



Stellate ganglion block, Horner’s syndrome, transcranial doppler


Background and Study Goal. Stellate ganglion block (SGB) has been used in the treatment of cerebral derangements associated with headache, for the purpose of reliving spasm and presumably increasing the cerebral blood flow, normalizing endovascular resistance.

Materials and Methods. 30 volunteers underwent unilateral SGB, 30–40 years (21 females, 9 males), with cluster headache. 5 ml 0,25 % ropivacaine were administered + 4 mg dexamethasone under C6 level paratracheal ultrasound guid. The confirmation was the presence of Horner´s syndrome. The resistive index (RI) was measured by ultrosound transcranial CV doppler of middle cerebral artery at the baseline and 1 min, and 10 min after SGB on both sides (the other side was taken for control). Normal values of RI corresponded to the age.

Results and discussion. Our observations showed that after SGB in all patients there was a significant change in RI with normalization of cerebral blood flow, reduction or disappearance of headache.

Conclusions. The difference between the block and the nonblock sides was significant before procedure (p < 0,0001) and after 10 min become the same with an insignificant difference (p = 0,001). A higher RI in patients with a cluster headache may be as an indicator for choosing the block side. Ultrasound technique will be helpfull for providing safe block and effect control.


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Hogan QH, Erickson SJ. MR imaging of the stellate ganglion: normal appearance. American Journal of Roentgenology [Internet]. American Roentgen Ray Society; 1992 Mar;158(3):655–9. Available from:

HOGAN QH, ERICKSON SJ, HADDOX JD, ABRAM SE. The Spread of Solutions During Stellate Ganglion Block. Survey of Anesthesiology [Internet]. Ovid Technologies (Wolters Kluwer Health); 1992 Dec;36(6):356. Available from:

Hogan QH, Abram SE. Neural Blockade for Diagnosis and Prognosis. Anesthesiology [Internet]. Ovid Technologies (Wolters Kluwer Health); 1997 Jan;86(1):216–41. Available from:

Hartzler GO, Osborn MJ. Invasive electrophysiological study in the Jervell and Lange-Nielsen syndrome. Heart [Internet]. BMJ; 1981 Feb 1;45(2):225–9. Available from:

Elias M. Cervical sympathetic and stellate ganglion blocks. Pain Physician. 2000 Jul;3(3):294-304.

COOK TC, DE SANCTIS CA, PLAZA JA, SAWYER DD. Stellate Ganglion Block for Sudden Profound Hearing Loss. Anesthesiology [Internet]. Ovid Technologies (Wolters Kluwer Health); 1981 May;54(5):421–2. Available from:

Malmqvist EL, Bengtsson M, Sörensen J. Efficacy of stellate ganglion block: a clinical study with bupivacaine. Reg Anesth. 1992 Nov-Dec;17(6):340-7.

Matsumoto S. Thermographic assessments of the sympathetic blockade by stellate ganglion block (1) Comparison between C7-SGB and C6-SGB in 40 patients. Masui. 1991 Apr;40(4):562-9.

Matsumoto S. [Thermographic assessments of the sympathetic blockade by stellate ganglion block (2)--Comparison and analysis of thermographic patterns between C7-SGB and C6-SGB in 20 healthy volunteers]. Masui. 1991 May;40(5):692-701.

STEVENS R. The relative increase in skin temperature after stellate ganglion block is predictive of a complete sympathectomy of the hand. Regional Anesthesia and Pain Medicine [Internet]. BMJ; 1998 May;23(3):266–70. Available from:

Elias M. The anterior approach for thoracic sympathetic ganglion block using a curved needle. The Pain Clinic [Internet]. Informa UK Limited; 2000 Mar;12(1):17–24. Available from:

Sluijter ME. Radiofrequency lesions in the treatment of cervical pain syndromes. Boston, Radionics Corp. 1990.

KUNTZ A. DISTRIBUTION OF THE SYMPATHETIC RAMI TO THE BRACHIAL PLEXUS. Archives of Surgery [Internet]. American Medical Association (AMA); 1927 Dec 1;15(6):871. Available from:

Abdi S, Zhou Y, Patel N, Saini B, Nelson J. A new and easy technique to block the stellate ganglion. Pain Physician. 2004 Jul;7(3):327-31.

Several aspects of stellate ganglion block



How to Cite

Yevstratov EP, Krupskaya NV, Shumlyanskiy VY. Several aspects of stellate ganglion block. PMJUA [Internet]. 2018Aug.1 [cited 2020Oct.1];3(2):62-6. Available from:



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