Clinical Outcomes Associated with Stellate Ganglion Block Across Multiple Pain Phenotypes
Zeki Boga1, Cagatay Kucukbingoz2, Ahmet Yilmaz2
1Department of Neurosurgery, Adana City Training and Research Hospital, Adana 01230, Turkey.
Journal of Clinical Medicine
|November 13, 2025
Summary
Stellate ganglion block (SGB) effectively reduced pain and improved function in patients with sympathetic dysfunction. Migraine and complex regional pain syndrome (CRPS) showed the most significant benefits, with SGB being well-tolerated.
Area of Science:
- Pain Medicine
- Interventional Pain Management
- Neurology
Background:
- Stellate ganglion block (SGB) is utilized for sympathetic dysfunction pain.
- Evaluating SGB's short-term outcomes across diverse pain phenotypes is crucial.
Purpose of the Study:
- Assess the clinical outcomes and tolerability of fluoroscopy-guided SGB.
- Compare SGB efficacy in patients with migraine, complex regional pain syndrome (CRPS), neuropathic, and nociceptive pain.
Main Methods:
- Retrospective analysis of 96 patients undergoing SGB.
- Utilized Visual Analog Scale (VAS), Oswestry Disability Index (ODI), and SF-36 for assessment.
- Follow-up at 1, 3, and 6 months post-procedure.
Main Results:
- Significant improvements in VAS, ODI, and SF-36 scores across all groups (p < 0.001).
- Migraine and CRPS groups demonstrated the largest VAS reductions, exceeding the minimal clinically important difference (MCID).
- Pain phenotype was the sole independent predictor of favorable outcomes, with migraine and CRPS showing the best response.
Conclusions:
- SGB is well-tolerated and provides significant pain reduction and functional improvement.
- Clinical benefits suggest peripheral and central sympathetic modulation.
- Further multicenter prospective studies are needed to validate findings.
Related Concept Videos
01:28Drugs Acting on Autonomic Ganglia: Blockers
1.6K
Ganglionic blockers inhibit autonomic activity by blocking nicotinic receptors in the autonomic ganglia, suppressing impulse transmission. These blockers lack selectivity between sympathetic and parasympathetic ganglia and are ineffective as neuromuscular junction antagonists. They can be categorized into two groups:
1.6K
01:25Analgesia and Pain Management
1.5K
Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
1.5K
01:24Local Anesthetics: Differential Sensitivity of Nerve Fibers
1.3K
Local anesthetics (LAs) block the sodium channels of nerve trunks, sensory nerve endings, and neuromuscular junctions. Although LAs can block all kinds of nerves, the sensitivity of nerve fibers differs according to nerve types and structures. LAs are known to block myelinated fibers faster than unmyelinated ones. Also, they block pain or sensory neurons at low concentrations without affecting the motor neurons involved in muscle contractions. This helps relieve labor pain without affecting the...
1.3K
01:30Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia
1.8K
Depending on the target organ, local anesthetics (LAs) can be administered via various routes. In surface anesthesia, LAs are applied directly to the surface of the skin or mucous membranes. It is widely used for topical skin numbing before venipuncture or minor surgical procedures. Commonly used surface local anesthetics are lidocaine or benzocaine sprays or creams. Surface anesthesia occurs within 5 minutes and lasts for about 60 minutes. One of the main disadvantages of topical anesthesia is...
1.8K