Stellate Ganglion Block (SGB).

What it is

The stellate ganglion is a cluster of nerves in the neck that relays fight-or-flight signals. A stellate ganglion block (SGB) is an ultrasound-guided injection of local anesthetic next to it, which briefly quiets that activity. Long used for certain pain conditions, it gained attention when military physicians saw PTSD symptoms ease in service members after a block.

Some people notice less hypervigilance, anxiety or trouble sleeping within hours or days, and the effect can outlast the anesthetic. How long it lasts varies, and many clinicians pair it with trauma therapy. Trials for PTSD are encouraging.

What happens at a visit

1. An assessment of your trauma history and symptoms.
2. Vital signs and a consent talk before the procedure.
3. Ultrasound-guided placement of a fine needle in the neck.
4. Injection of a local anesthetic, such as lidocaine or ropivacaine, over 1 to 2 minutes.
5. A droopy eyelid or flushed face for a few hours, a sign the block worked.
6. 30 to 60 minutes of observation and a check on how you feel.

Who it is for

• Veterans and first responders with PTSD
• People with anxiety or panic that hasn't improved with other treatment
• Trauma survivors for whom therapy alone hasn't been enough
• People who feel stuck in fight-or-flight
• People with severe hot flashes
• People with complex regional pain syndrome (CRPS)

Evidence and safety

SGB has been used for pain for decades, and a randomized, sham-controlled trial found it eased PTSD symptoms; results vary and research continues. A droopy eyelid, hoarseness and trouble swallowing are common and fade within hours. Rare risks include bleeding, infection and a collapsed lung, so tell your doctor if you take blood thinners. It should be done by a physician trained in ultrasound-guided injections.

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