Lumbar Sympathetic Plexus (Ganglion) Block

A ganglion block is an injection of local anesthetic in the sympathetic nerve tissue of the neck. The injection may contain both steroids and anesthetic and is administered to relieve the patient of localized pain.

General Pre-lnjection Instructions:

Be sure to inform our staff if you have an allergy, particularly to iodine.  If you will be receiving sedation, you should NOT eat the morning of the procedure.  If a patient is an insulin dependent diabetic and receiving sedation, they may need to change their morning dose of insulin to account for not eating the morning of the procedure.  Patients may take their routine medications (i.e., high blood pressure and diabetic medications, e.g. Glucophage).

Patients should continue to take pain medications or anti-inflammatory medications the day of their procedure.  If a patient is on Coumadin or another blood thinner, they should notify the staff so an appropriate plan can be made for stopping the medication before the procedure.  We generally recommend that a driver should accompany the patient and be responsible for getting them home.

Ganglion block procedure

An IV will be started before the procedure.  The patient is placed on the procedure table on their back for a stellate ganglion (neck) block and on their stomach for a lumbar (low back) block.  The skin on the neck or the skin on the low back is scrubbed using antibacterial soap. The physician numbs a small area of skin with numbing medicine.  This medicine stings for several seconds. After the numbing medicine has been given time to be effective, the physician directs a very small needle to the area of the sympathetic nerves using x-ray guidance.  A small amount of contrast (dye) is injected to ensure proper needle position. Then, local anesthetic is administered to achieve the sympathetic block.

What happens after the procedure?

Immediately after the procedure, the patient will be examined and will be asked to report the percentage of pain relief.  The arm(s), chest wall or leg(s) may feel weak or numb for a few hours. It is a temporary response to the local anesthetic used for the block and will wear off. Other potential reactions to the blocks will be discussed at the time of the procedure.  Patients may return to their normal activities on the day of the procedure. Driving is discouraged on the day of the procedure.