Sympathetic ganglion nerve block
Sympathetically mediated pain occurs when the sympathetic component of the autonomic nervous system is dysfunctional. One can think of it as being on “overdrive.” Symptoms typically include limb swelling, change in skin color and texture, and severe hypersensitivity to touch. Such syndromes occur from blunt trauma to an arm or leg, or after organ damage such as a heart attack. Research data clearly shows the effectiveness in decreasing pain with early intervention of sympathetic ganglion nerve blocks. The sympathetic block appears to interrupt and reset the dysfunctional autonomic nervous system, while the resulting analgesia also permits more aggressive rehabilitation.Using a low concentration of local anesthetic, lumbar (lower extremity) sympathetic blockade can be performed centrally by blocking the lumbar sympathetic nerve plexus directly via the epidural space. Cervical (upper extremity) sympathetic blocks are performed by anesthetizing the stellate ganglion, which is located at the base of the front of the neck. Under fluoroscopic guidance, a low concentration of anesthetic is injected through a specifically designed block needle.Side effects include temporary eyelid droop and redness of the eye, which actually helps confirm successful blockade of the ganglion. In addition, hoarseness, increased temperature on the face and arm of the injected side, as well as decreased sweating in the same areas are also observed. If administered early in the event of sympathetically mediated pain, even a single block can permanently relieve pain. However, sympathetic blocks must usually be repeated daily or every other day until the pain is controlled over the course of a few weeks.