Carol Bender, NP, explains the necessary steps that you’ll need to follow before your stellate ganglion block procedure.
PRE-PROCEDURE CARE:
- You will be emailed a questionnaire and the PCL checklist when you schedule your appointment. Please complete these required forms before your SGB appointment.
- Three days before your appointment, STOP taking fish oil and any blood thinners (such as Coumadin, Heparin, aspirin and ALL NSAIDS such as Advil, Motrin, etc.). The SGB treatment uses a medication that dilates blood vessels which, if paired with fish oil or blood thinners, could cause excessive bleeding and other complications.
- If at all possible, arrange for someone to drive you home. It is best if you do not have to deal with the stress of driving and traffic immediately after the treatment.
- Notify provider of allergies – to medications, latex, etc.
- Refrain from caffeine, nicotine, and any other stimulants for 24 hours prior to the procedure and at least 12 hours post procedure. It is important that there are no stimulants in your system at the time of treatment.
- Notify the provider of any anxiety issues (about injections, procedures, etc.).
- You may receive an IV (to deliver anti-anxiety or anti-nausea medication, for example).
- You should plan to spend up to an hour at the clinic for the procedure and post-procedure evaluation.
THE PROCEDURE:
- You will receive the stellate ganglion block while you are awake and lying on the exam table.
- You will be asked to remove any jewelry from around the treatment area (head and neck).
- An ultrasound probe will be placed on your neck to locate the stellate ganglion.
- A small amount of local anesthetic will be injected to numb the treatment site.
- Using real-time ultrasound guidance, about 13 milliliters of long-acting anesthetic (0.5% Ropivicane) will be slowly injected into two areas of the stellate ganglion. This may cause slight discomfort. (Although an injection in the neck can cause anxiety, it is not that bad.)
- If you have ANY strange or new sensations during the injection, let the physician know immediately. It is safe to speak during the injection, but it is important that you remain still.
- The providers will repeatedly ask how you are doing during and after the injection, so they can track the symptoms they expect to occur. Your responses help them determine if the injection is working correctly.
POST-PROCEDURE CARE:
- You will remain lying down on the exam table for a few minutes for observation. You may also be asked to rest in the waiting room for a bit longer if the providers feel it necessary.
- Since you will not be sedated, you can resume light activities for the remainder of the day. However, you should avoid rigorous exercise that might strain your neck. Walking is fine.
- You can expect to have a droopy eyelid and a bloodshot eye on the side that was treated, and facial flushing. These symptoms should resolve in about 8 hours.
- Do not smoke, use nicotine, caffeine, alcohol, or any stimulants for the first 12 hours post procedure.
PLEASE CALL THE CLINIC IMMEDIATELY IF YOU NOTICE ANY STRANGE OR NEW SENSATIONS AFTER YOU LEAVE. IF THE CLINIC DOES NOT RESPOND, CALL 911 AND GO TO THE NEAREST EMERGENCY ROOM. - To determine the effectiveness of the SGB and the need for a follow-up treatment, you will be requested to repeat the PCL checklist at several intervals after the procedure. PLEASE FILL OUT THESE FORMS. Doing so helps us to assess your progress.
- If you feel this procedure significantly helped you, you may wish to repeat it if you feel the effects are wearing off. There are currently no recommendations for how often to repeat the SGB but usually no more frequently than every three months. Repeat injections may be required in some cases for optimal effects.
2 WEEKS POST-PROCEDURE
We will email you inviting your response. If you like, we will arrange for one of our nurses to call and check in with you.
2 MONTHS POST-PROCEDURE
You will be asked to submit another PCL checklist and one of our nurses will call you to check how you are doing and review your PCL score with you. There is no charge for this follow-up call. Call our nurse helpline (619-876-0700) or office (858-609-0866) if you have post-procedure questions or concerns.
