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Cervical Sympathetic Chain and Superior Cervical Ganglion Block

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Regional Nerve Blocks in Anesthesia and Pain Therapy

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Abstract

A range of indications and case reports highlight the potential benefits of a stellate ganglion block (SGB), although the effects may only be short-lived and may require repeat injections. Concurrent with the advent of ultrasound guidance technology, the SGB has become a sympatholytic procedure that can now be safely performed without the need for fluoroscopy or blind palpation techniques. In addition to the risk of potential complications with traditional approaches for SGB, precision in the deposition of the injectate and adequacy of its spread to the first and second thoracic vertebral levels are key considerations for ensuring efficacy.

The SCG is the largest of the three cervical sympathetic ganglia. The SCG block indications are mostly identical to those for the stellate ganglion block. However, due to its marked cerebro-facial effects, the superior cervical ganglion block (SCGB) is particularly suitable in situations where pain or dysfunction involves the head and face, and it may be an option in depressive conditions. The description of how to block the SCG using ultrasonography was first reported in 2013, utilizing a cadaveric model to confirm the approach’s accuracy.

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Authors and Affiliations

  1. Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, ON, Canada

    Paul Tumber

  2. Pain Management Centre DGS – Cologne – Huerth, Cologne-Hurth, Germany

    Danilo Jankovic

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  1. DGS – Cologne – Huerth, Cologne-Hürth, Germany

    Danilo Jankovic

  2. Department of Anesthesia and Pain Medicine, Toronto Western Hospital, Toronto, ON, Canada

    Philip Peng

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Tumber, P., Jankovic, D. (2022). Cervical Sympathetic Chain and Superior Cervical Ganglion Block. In: Jankovic, D., Peng, P. (eds) Regional Nerve Blocks in Anesthesia and Pain Therapy. Springer, Cham. https://doi.org/10.1007/978-3-030-88727-8_12

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