Stellate Ganglion Block

What is the Stellate Ganglion Block (SGB)?

The stellate ganglion block (SGB) is a 100 year old, minimally invasive procedure where local anesthetic is injected around the stellate ganglion, the bundle of nerves in your neck that controls your fight-flight response. By temporarily blocking these nerves, an SGB can reset triggers-response pathways, pain signals, reduce inflammation, and restore balance to the autonomic nervous system.

By quieting the fight-flight response, the Stellate Ganglion Block can reduce intrusive thoughts, flashbacks, hyperarousal, and many other symptoms of an overactive sympathetic nervous system

What is the Dual Sympathetic Reset (DSR)?

The Dual Sympathetic Reset (DSR) is a modified Stellate Ganglion Block that more specifically targets specific mental health conditions. It involves performing two injections along the bundle of nerves: one at the 4th cervical level, and the other at the 6th cervical level. This can lead to significant improvements in mood and energy.

What Conditions is SGB Good For?

The SGB/DSR can be effective in multiple conditions:

• Post-traumatic stress disorder (PTSD)
• Anxiety and irritability (related to being on-edge)
• Sleep disturbances (related to flashbacks and nightmares)
• Long COVID (in particular memory and fatigue-related symptoms and taste/smell disturbances)
• Hot flashes
• Chronic fatigue
• Stress-related constipation
• Migraines
• Chronic pain

How Does the SGB Procedure Work?

The SGB/DSR is a short procedure, lasting only 15 minutes. However, the entire appointment lasts about 90 minutes to ensure proper monitoring after the block is complete.

1. Preparation: The patient lies down comfortably, and the skin on the side of the neck is cleaned and numbed with a topical anesthetic.
2. Sedation: About half of patients request IV sedation medication. This is optional and is available for the comfort of the patient. If you receive sedation, you will need a ride back home as you won't be able to drive the rest of the day.
3. Imaging Guidance:  Ultrasound is used to precisely visualize the stellate ganglion and ensure accurate needle placement.
4. Injection: A small needle is inserted, and a local anesthetic is injected around the stellate ganglion.
5. Monitoring:  The patient is monitored for 60 minutes after the injection to observe for any side effects.

You can watch a patient's experience with the Stellate Ganglion Block here:

Can SGB be Combined with IV Ketamine Therapy?

SGB and Ketamine have many synergistic effects and can "reset" the nervous system when it is stuck. This is especially helpful in certain cases:

• Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS): combining IV Ketamine and SGB can produce synergistic results
• PTSD and depression
• Chronic pain
• Migraines

This may be because both the Stellate Ganglion Block (SGB) and IV Ketamine support neuroplasticity, providing the potential for "resetting" neural pathways for extended periods of time.

How Long Does Symptom Relief with SGB Last?

The improvement in symptoms can last anywhere from weeks to years (on average 2-3 months). It depends on many factors, especially how the body is "resetting" during the first few weeks after the SGB in performed. For example, combining cognitive behavioral therapy (CBT) with SGB is believed to provide better results than just performing the SGB alone.

What Are the Side Effects of the Stellate Ganglion Block (SGB)?

The SGB is a very safe procedure when performed by an expert and when the patient is optimized for the procedure. Like any procedure, there are potential side effects, though serious side effects are rare.

There are specific signs that Dr. Kaveh will examine for to ensure the block was successful. These side effects are the opposite of the fight-flight response, and indicate that the Stellate Ganglion was indeed numbed well:

• Horner's syndrome (droopy eyelid, constricted pupil)
• Warmth of the arm (blood vessel relaxation in the arm)
• Nasal congestion or stuffiness (blood vessel relaxation in the face)
• Redness in the eye (blood vessel relaxation in the eye)

These side effects are temporary and are the result of blocking the sympathetic nervous system. They indicate a successful SGB.

Speak with Clarus Health to Start Your Healing Journey with SGB

The decision to pursue SGB/DSR depends on many factors, including the holistic benefits of treating your mental health. You deserve to learn your treatment options for safe and rapid results. You should always speak with your doctors to learn about the risks and benefits of SGB so you can make an informed decision. Contact Clarus Health to learn about your treatment options.