Duration of a Ganglion stellatum blockage
Experienced anesthetists need only a few minutes for the puncture and injection. With preparation and subsequent monitoring, a blockage takes about 1 hour. If a series of blockades is performed with up to 10 sessions at intervals of 1-3 days, the therapy can last for a month.
What are the risks?
A possible risk is the injection of the local anesthetic into the vertebral artery (Arteria vertebralis), which runs past the back of the transverse processes. If local anesthetic is injected intravascularly (into the vessel), a seizure is triggered immediately. Therefore, the procedure should be performed under intubation readiness.
The spread of the local anesthetic in the tissue can lead to recurrent paresis, i.e. damage to the recurrent nerve (laryngeal nerve). The consequences are hotness, coughing and even shortness of breath.If the recurrence is anaesthetized on both sides, the vocal cords are completely closed, breathing is no longer possible in this case. Therefore a stellate block is only performed on one side.
Furthermore, the nerve plexus of the arm can be anaesthetised for a short time. Those affected can temporarily move the arm/hand with difficulty (see: Brachial plexus paralysis). If a patient takes blood thinners or suffers from a blood coagulation disorder, bruising may occur in the area of the spur canal.
The consequences are swelling, pain or paralysis due to constriction of adjacent nerves. By inserting the needle, the tip of the lung can be injured and cause a so-called pneumothorax. The affected lung is reduced in size and makes breathing more difficult. If there is already a pneumothorax on the opposite side or if there is a respiratory failure, a stellate blockage must not be performed! Extremely rarely, the trachea (irritation of the throat) or esophagus is injured.
What results can be expected?
First, the effectiveness of the nerve block should be tested. For this purpose at least two diagnostic punctures should be performed. If the pain is significantly reduced after 4 days, the therapeutic blockade series can be started.
After the 5th blockade, a break is taken to check the success of the therapy. To be able to show the success of the therapy, it can be helpful to keep a pain diary. If pain occurs again, the series can be continued.
Nerve blocks have a high placebo effect. It is always necessary to critically question the success of the therapy. The success rates vary considerably between 30-90% depending on the symptoms. In order to achieve long-term success, additional physiotherapy and relaxation exercises should not be avoided.
