LKnative – Stellate ganglion block

Indications

Reflex dystrophia of the upper limb.

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Sympathetic trunk anatomy

The sympathetic trunks are paired chains of ganglionated nerve strands descending anterior to the vertebral column. They start separately at the base of the skull as plexuses around the internal carotid artery on each side and they end at the coccygeal bone where they fuse as the ganglion impar.

The sympathetic trunks are part of the autonomic nervous system. On each side white rami run from the spinal cord to the sympathetic trunk, and gray rami run from the sympathetic trunk to each spinal nerve.

The inferior cervical ganglion of the sympathetic trunk is oftentimes fused with the first thoracic paravertebral ganglion. The fused ganglion is called “the stellate ganglion”.

The sympathetic trunk descends anterior to the longus colli muscle, which is anterior to the transverse processes of the cervical vertebral bodies. The longus colli muscle origins from the anterior tubercles and transverse processes of vertebrae C3-T3 and inserts on the anterior tubercles of transverse processes C5-C6 and the anterior surfaces of the vertebral bodies C2-C4 and atlas.