Efficacy Of Clonidine & Steroid In Stellate Ganglion Block

Stellate ganglion block (SGB) is commonly indicated in painful conditions of upper extremity head and neck like complex regional pain syndrome head and neck malignancy vascular insufficiency of the upper limb and many others. It is utilized in the diagnosis and management of various vascular disorders and sympathetically mediated pain in upper extremity head and neck. The cervical sympathetic chain is composed of superior middle intermediate and inferior cervical ganglia. However in approximately 80% of population inferior cervical ganglion is fused with first thoracic ganglion forming the stellate ganglion also known as cervicothoracic ganglion. The stellate ganglion lies medial to the scalene muscles lateral to longus colli muscle esophagus and trachea along with recurrent laryngeal nerve anterior to transverse process and prevertebral fascia superior to the subclavian artery and posterior to vertebral vessels at C7 level. Consequently inadvertent placement of the needle tip into these soft tissues and vessels occur with blind or fluoroscopy guided SGB. Sonographic guidance may prevent such complications.