Stellate ganglion block

Understanding the procedure

A stellate ganglion block (SGB) is an advanced, minimally invasive procedure targeting the stellate ganglion, a collection of sympathetic nerves located in the lower neck. While traditionally used for chronic pain syndromes, SGB is increasingly used as a tool for modulating the fight-or-flight response in patients experiencing severe, treatment-resistant neuropsychiatric symptoms, such as severe anxiety, panic, hypervigilance, and trauma-induced autonomic dysregulation.

How it works

Chronic stress or trauma can leave the sympathetic nervous system locked in a permanent state of high alert. SGB temporarily blocks these overactive nerve pathways, acting as a hardware reset to restore autonomic balance. The injection interrupts fight-or-flight signals between the body and brain, signals the amygdala that danger has passed, and creates a lasting state of calm that allows the brain to rewire and enhances the effectiveness of therapies such as EMDR.

Compared with psychiatric medications, which manage symptoms chemically over weeks, SGB offers a rapid structural reset. Many patients experience a profound and rapid reduction in physical trauma symptoms, such as a racing heart, chronic hypervigilance, night terrors, and sudden panic surges, often within hours of the procedure.

Before your procedure

Fasting, sedation, and your ride home

• If you are receiving sedation, nothing to eat or drink for six hours before your appointment. Essential morning medications may be taken with a small sip of water only.
• We offer light or deep sedation. The level is decided by the physician and anesthesia team based on the procedure and clinical need.
• Any patient receiving sedation must be accompanied by a responsible adult driver to take them home.

Where to go

Procedures are performed at one of three facilities: our clinic at 1925 Hospital Place, ACOM at 6449 Central Park Blvd, or Hendrick South at 6399 Directors Pkwy, Suite 100. Your appointment paperwork tells you which one. Please arrive early for registration and pre-procedure preparation.

Procedure day

• The procedure occurs in a comfortable outpatient clinic with local numbing and optional light sedation.
• Family or friends can accompany and support you during the injection, as you choose.
• The injection takes 10 minutes, followed by a 15-to-30-minute observation period.
• A successful block may cause temporary Horner's syndrome on the injected side (drooping eyelid, constricted pupil, bloodshot eye), which resolves within hours as the anesthetic wears off.

Afterward: what to expect

• Right after the block. A drooping eyelid, constricted pupil, or bloodshot eye on the injected side is a sign the block reached its target. It resolves within hours.
• The first hours. Immediate relaxation and mental clarity are common once the numbing agent wears off.
• The months after. The reset can last months. Continue your mental health treatment alongside it; that is where the lasting gains are made.

Call us right away if you notice

This guide is the same information as the printed handout from Abilene Pain. It is general information and does not replace the instructions your care team gives you at your visit. Your care team: Nicolas Pugh, MD · Adrianne Anders, NP · Ted Chaka, PA.