Peri-operative Analgesia With a Stellate Ganglion Block For Upper Extremity Surgery

The stellate ganglion nerve block selectively inhibits the sympathetic innervations of the upper limb, head and neck while preserving sensory and motor functions. The sympathetic nervous system is activated when the body... [ view full abstract ]

The stellate ganglion nerve block selectively inhibits the sympathetic innervations of the upper limb, head and neck while preserving sensory and motor functions. The sympathetic nervous system is activated when the body experiences stresses such as pain. The sympathetic nervous system also influences arteriolar tone, which may modify pain by washing out the inflammatory mediators which sensitize nociceptors. Clinically, the stellate ganglion block is often used for treating chronic pain conditions. Recent studies have showed that the block also has potential for use perioperatively to reduce post-operative pain scores, opiate consumption and opiate side effects. We present a case in which the stellate ganglion block was performed preoperatively instead of a brachial plexus nerve block to improve postoperative analgesia while also allowing for immediate post-operative motor function testing.