What is the stellate ganglion, and where is it?
The stellate ganglion is a bundle of sympathetic nerves in the front of the neck, near the first ribs. There is one on each side, shaped like an oval or a star.
It sends most of the sympathetic signal to the head, neck, arms and upper chest. Sympathetic nerves help control heart rate, blood pressure and sweating, and they run the fight-or-flight response.
How does the block work?
Under ultrasound, a physician places a local anesthetic around the nerve bundle. The anesthetic quiets the sympathetic signal passing through it for a time.
Ultrasound shows the blood vessels and soft tissue around the ganglion, which X-ray guidance cannot. That view helps place the needle and watch where the anesthetic spreads.
Why treat both sides?
There is a stellate ganglion on each side of the neck, and a dual block treats both. At Reboot Vitality that happens on two consecutive days: the right side first, the left side the next day.
Much of the published research, including the 2020 JAMA Psychiatry trial, used right-side blocks only. The two-sided approach has less published evidence.
How might calming this nerve bundle affect stress?
Researchers are still working this out. One idea is that the block lowers nerve growth factor, which reduces norepinephrine and the extra sympathetic activity seen in PTSD.
"Reset" describes the aim: a stress response that settles out of survival mode for a time. Using a stellate ganglion block for stress-related conditions is an off-label use. Dr. Meighen reviews the benefits and risks with you before anything is scheduled.
What signs show the block has taken effect?
Doctors often look for Horner's syndrome, which includes a droopy eyelid and a smaller pupil on the injected side. Other common effects are a warm face, a red or watery eye, a stuffy nose, a hoarse voice and trouble swallowing. The arm on that side can feel warm, heavy or numb.
These usually go away within a few hours. Serious complications are rare, and they include infection, bleeding, nerve injury, a collapsed lung and an allergic reaction. If the anesthetic reaches a blood vessel, it can cause a seizure or a change in heart rhythm, which is why the team watches you for 30 to 45 minutes.
How long does the effect last after the anesthetic wears off?
The local anesthetic itself wears off within hours. The 2020 trial measured PTSD symptoms over 8 weeks, and the VA's patient guide says the long-term effects are unknown.
How long any calming effect lasts differs from person to person. Individual experiences vary.
How is it done at Reboot Vitality?
Dr. Michael Meighen evaluates you first, then performs both sides himself. After each injection the team monitors you for 30 to 45 minutes, and you can drive yourself home afterward.
You can read about the dual stellate ganglion block in Tampa, day by day. It sits with BrainTap and the Dopamine Chair in phase one, the nervous system reset.
Common questions
Is a dual stellate ganglion block painful?
A thin needle is used in the front of the neck, and soreness or bruising at the site afterward is a common side effect. How it feels differs from person to person.
Are both sides treated together?
No. At Reboot Vitality the right side is treated on day one and the left side on day two, each followed by monitoring.
Does the block change the brain?
The block acts on nerves in the neck. Researchers think its effect on stress signaling reaches further, and how that works is still being studied.
Is a dual stellate ganglion block covered by insurance?
Ask the team about insurance, including Tricare, before you book.