Physiologic effects of stellate ganglion block: a result of complete ganglion blockade or the vertical spread of local anesthetic?

Traditionally, stellate ganglion blockade has been used for the diagnosis and treatment of upper extremity sympathetic pain. However, this treatment has not been shown to provide adequate sympathetic blockade of the upper extremities. This study demonstrates that a carefully performed upper thoracic sympathetic block with imaging guidance can result in a successful sympathetic blockade of the upper extremities. This study furthermore demonstrates that the occurrence of a Horners syndrome is not a testimony to a successful sympathetic block of the upper extremities.