stellate ganglion


Summary: A paravertebral sympathetic ganglion formed by the fusion of the inferior cervical and first thoracic ganglia.

Top Publications

  1. Wang Q, Wang X, Fu N, Liu J, Yao S. Stellate ganglion block inhibits formalin-induced nociceptive responses: mechanism of action. Eur J Anaesthesiol. 2005;22:913-8 pubmed
    b>Stellate ganglion block has been extensively used in clinical practice for the management of painful conditions such as cephalic, facial and upper limb pains yet its mechanism of action and its analgesic efficacy are poorly understood...
  2. Yucel I, Demiraran Y, Ozturan K, Degirmenci E. Complex regional pain syndrome type I: efficacy of stellate ganglion blockade. J Orthop Traumatol. 2009;10:179-83 pubmed publisher
    This study was performed to evaluate the treatment of complex regional pain syndrome (CRPS) type I with stellate ganglion blockade. We performed three blockades at weekly intervals in 22 patients with CRPS type I in one hand...
  3. Haest K, Kumar A, Van Calster B, Leunen K, Smeets A, Amant F, et al. Stellate ganglion block for the management of hot flashes and sleep disturbances in breast cancer survivors: an uncontrolled experimental study with 24 weeks of follow-up. Ann Oncol. 2012;23:1449-54 pubmed publisher
    We studied the stellate ganglion block (SGB) recently suggested for the treatment of severe vasomotor symptoms and sleep disturbances in breast cancer survivors...
  4. Merriam L, Locknar S, Girard B, Parsons R. Somatic ATP release from guinea pig sympathetic neurons does not require calcium-induced calcium release from internal stores. Am J Physiol Cell Physiol. 2010;299:C836-43 pubmed publisher
    ..Although a caffeine-induced release of Ca(2+) from internal stores can elicit both SICs and ASTICs in dissociated sympathetic neurons, CICR is not required for the somatic release of ATP. ..
  5. Ackerman W, Zhang J. Efficacy of stellate ganglion blockade for the management of type 1 complex regional pain syndrome. South Med J. 2006;99:1084-8 pubmed
    The purpose of this study was to examine the efficacy of stellate ganglion blockade (SGB) in patients with complex regional pain syndromes (CRPS I) of their hands.
  6. Swissa M, Zhou S, Paz O, Fishbein M, Chen L, Chen P. Canine model of paroxysmal atrial fibrillation and paroxysmal atrial tachycardia. Am J Physiol Heart Circ Physiol. 2005;289:H1851-7 pubmed nerve growth factor infusion (n = 4 dogs) or subthreshold electrical stimulation (n = 4 dogs) of the left stellate ganglion. Cardiac rhythm was continuously monitored by a Data Sciences International transmitter for 48 (SD 27) days...
  7. Hou Y, Hu J, Po S, Wang H, Zhang L, Zhang F, et al. Catheter-based renal sympathetic denervation significantly inhibits atrial fibrillation induced by electrical stimulation of the left stellate ganglion and rapid atrial pacing. PLoS ONE. 2013;8:e78218 pubmed publisher
    ..To establish a hyper-sympathetic tone canine model of AF, sixteen dogs were subjected to stimulation of left stellate ganglion (LSG) and rapid atrial pacing (RAP) for 3 hours...
  8. Schurmann M, Gradl G, Wizgal I, Tutic M, Moser C, Azad S, et al. Clinical and physiologic evaluation of stellate ganglion blockade for complex regional pain syndrome type I. Clin J Pain. 2001;17:94-100 pubmed
    The efficacy of peripheral sympathetic interruption after stellate ganglion blockade was assessed by a sympathetic function test...
  9. Higa K, Hirata K, Hirota K, Nitahara K, Shono S. Retropharyngeal hematoma after stellate ganglion block: Analysis of 27 patients reported in the literature. Anesthesiology. 2006;105:1238-45; discussion 5A-6A pubmed
    Retropharyngeal hematoma (RPH) is rare; however, it causes airway obstruction and can be fatal. Stellate ganglion block (SGB) can cause RPH...

More Information


  1. Tuz M, Erodlu F, Dodru H, Uygur K, Yavuz L. Transient locked-in syndrome resulting from stellate ganglion block in the treatment of patients with sudden hearing loss. Acta Anaesthesiol Scand. 2003;47:485-7 pubmed
    b>Stellate ganglion blockage (SGB) is a local anesthetic procedure intended to block the lower cervical and upper thoracic sympathetic chain and is one of the treatment modalities for a wide range of disorders such as sudden hearing loss, ..
  2. Pardini B, Lund D, Schmid P. Innervation patterns of the middle cervical--stellate ganglion complex in the rat. Neurosci Lett. 1990;117:300-6 pubmed
    ..the distribution of innervation of the middle and inferior cervical ganglia in the rat (middle cervical-stellate ganglion complex), the sympathetic ganglia which give rise to virtually all cardiac sympathetic nerves...
  3. Yildirim V, Akay H, Bingol H, Bolcal C, Iyem H, Doganci S, et al. Pre-emptive stellate ganglion block increases the patency of radial artery grafts in coronary artery bypass surgery. Acta Anaesthesiol Scand. 2007;51:434-40 pubmed
    We evaluated the role of pre-emptive stellate ganglion block (SGB) in preventing radial artery spasm and increasing radial artery graft patency in patients undergoing off-pump coronary artery bypass surgery.
  4. Zhao N, Khan M, Ingenito S, Sica A, Gootman N, Gootman P. Electrocardiographic changes during postnatal development in conscious swine with cardiac autonomic imbalance. Auton Neurosci. 2001;88:167-74 pubmed
    ..Newborn pigs were assigned randomly to four different groups: sham-operated controls (C), stellate ganglion ablation (SGX), either left (LSGX) or right (RSGX), and the right cardiac vagus nerve (RCVX) transection...
  5. Tong S, Ingenito S, Anderson J, Gootman N, Sica A, Gootman P. Development of a swine animal model for the study of sudden infant death syndrome. Lab Anim Sci. 1995;45:398-403 pubmed
    ..The cause of death for these three animals could not be determined (necropsy was not revealing) because they were not monitored at the time of their demise.(ABSTRACT TRUNCATED AT 250 WORDS) ..
  6. Ogawa M, Tan A, Song J, Kobayashi K, Fishbein M, Lin S, et al. Cryoablation of stellate ganglia and atrial arrhythmia in ambulatory dogs with pacing-induced heart failure. Heart Rhythm. 2009;6:1772-9 pubmed publisher
    ..Cryoablation of bilateral stellate and T2-T4 thoracic ganglia significantly reduced paroxysmal atrial tachycardia and prolonged sinus pause episodes induced by sympathetic discharges in dogs with pacing-induced HF. ..
  7. Tan A, Zhou S, Ogawa M, Song J, Chu M, Li H, et al. Neural mechanisms of paroxysmal atrial fibrillation and paroxysmal atrial tachycardia in ambulatory canines. Circulation. 2008;118:916-25 pubmed publisher
    ..After baseline recording, we paced the left atrium at 20 Hz for 1 week and then monitored left stellate ganglion nerve activity, left vagal nerve activity, and left atrial electrogram without pacing for 24 hours...
  8. Tompkins J, Parsons R. Exocytotic release of ATP and activation of P2X receptors in dissociated guinea pig stellate neurons. Am J Physiol Cell Physiol. 2006;291:C1062-71 pubmed
    ..These results suggest that ASTICs are mediated by vesicular release of ATP and activation of P2X receptors. ..
  9. Ewert T, Gritman K, Bader M, Habecker B. Post-infarct cardiac sympathetic hyperactivity regulates galanin expression. Neurosci Lett. 2008;436:163-6 pubmed publisher
    ..These data suggest that post-infarct cardiac sympathetic hyperactivity stimulates galanin peptide production but is not required for increased galanin mRNA expression. ..
  10. Shen M, Shinohara T, Park H, Frick K, Ice D, Choi E, et al. Continuous low-level vagus nerve stimulation reduces stellate ganglion nerve activity and paroxysmal atrial tachyarrhythmias in ambulatory canines. Circulation. 2011;123:2204-12 pubmed publisher
    ..12 dogs to stimulate the left cervical vagus nerve and a radiotransmitter for continuous recording of left stellate ganglion nerve activity, vagal nerve activities, and ECGs. Group 1 dogs (N=6) underwent 1 week of continuous LL-VNS...
  11. Gonsalvez D, Cane K, Landman K, Enomoto H, Young H, Anderson C. Proliferation and cell cycle dynamics in the developing stellate ganglion. J Neurosci. 2013;33:5969-79 pubmed publisher
    ..We measured cell cycle dynamics in the embryonic mouse sympathetic stellate ganglion, where neuroblasts continue to proliferate following neuronal differentiation. At embryonic day (E) 9...
  12. Klein R, Burk D, Chase P. Anatomically and physiologically based guidelines for use of the sphenopalatine ganglion block versus the stellate ganglion block to reduce atypical facial pain. Cranio. 2001;19:48-55 pubmed is designed to develop guidelines needed for the use of a sphenopalatine ganglion block versus a stellate ganglion block to reduce atypical facial pain...
  13. Adachi M, Otsuki M, Akatsu M, Tase C. [The effects of heat stimulation and cold stress on the rats with cervical sympathectomy]. Masui. 2003;52:1293-9 pubmed
    To investigate the general action of stellate ganglion block (SGB), we examined the effects of heat stimulation and cold stress on the behavior and stress hormone of the bilateral cervical sympathectomy rats as a long-term and repeated ..
  14. Lee C, Chuang C, Liou J, Hsieh Y, Tsou M, Chen K. Successful management of contrast medium extravasation injury through stellate ganglion block and intra-arterial nitroglycerin. Acta Anaesthesiol Taiwan. 2011;49:116-8 pubmed publisher
    We describe the successful management of extravasation injury to the left hand by contrast medium with stellate ganglion block and intra-arterial nitroglycerin in a patient which befell during contrast-enhanced imaging...
  15. Gutiérrez Ruiz M, Robles Díaz G, Kershenobich D. Emerging concepts in inflammation and fibrosis. Arch Med Res. 2002;33:595-9 pubmed
    ..Molecules that down-regulate this response are overexpressed. Therapeutic strategies with targeting to such mechanisms underlying chronic hepatic and pancreatic injury are an emerging reality. ..
  16. Rastogi S, Tripathi S. Cardiac arrest following stellate ganglion block performed under ultrasound guidance. Anaesthesia. 2010;65:1042 pubmed publisher
  17. Larsen H, Bardsley E, Lefkimmiatis K, Paterson D. Dysregulation of Neuronal Ca2+ Channel Linked to Heightened Sympathetic Phenotype in Prohypertensive States. J Neurosci. 2016;36:8562-73 pubmed publisher
  18. Lameris T, de Zeeuw S, Duncker D, Tietge W, Alberts G, Boomsma F, et al. Epinephrine in the heart: uptake and release, but no facilitation of norepinephrine release. Circulation. 2002;106:860-5 pubmed
    ..16+/-0.08 up to 228+/-39 nmol/L) epinephrine concentrations were found, but NE(MIF) did not change. Left stellate ganglion stimulation increased NE(MIF) from 3.4+/-0.5 to 8.2+/-1...
  19. Benyamin R, Kramer J, Vallejo R. A case of spinal cord stimulation in Raynaud's Phenomenon: can subthreshold sensory stimulation have an effect?. Pain Physician. 2007;10:473-8 pubmed
    ..severe Raynaud's phenomenon in the hands refractory to conservative treatment and responsive to diagnostic stellate ganglion block that was effectively treated with a spinal cord stimulator placed in the cervical epidural space...
  20. Gavrilovic L, Mandusić V, Stojiljković V, Kasapovic J, Stojiljković S, Pajovic S, et al. Effect of chronic forced running on gene expression of catecholamine biosynthetic enzymes in stellate ganglia of rats. J Biol Regul Homeost Agents. 2012;26:367-77 pubmed
    ..The results presented here suggest that the continuous increase of the noradrenaline biosynthetic enzyme expression in stellate ganglia due to CFR may play a role in growing risk of cardiovascular diseases. ..
  21. Brenner G, Newmark J, Nemark J, Raemer D. Curriculum and cases for pain medicine crisis resource management education. Anesth Analg. 2013;116:107-10 pubmed publisher
    ..Here, we present an educational curriculum in pain medicine crisis resource management for both pain medicine fellows and attending physicians as well as the results of a successful pilot program. ..
  22. Vititnova M, Kryzhanovskiĭ S, Kaverina N. [Comparative study of the anti-arrhythmic activity of cardiocyclide and nibentan in hypersympathotonia and acute myocardial ischemia]. Eksp Klin Farmakol. 2002;65:24-6 pubmed
    ..2 mg/kg) exhibited pronounced antiarrhythmic activity. It is suggested that both drugs can be used under clinical conditions for the prophylaxis of sudden coronary death in patents with acute myocardial infarction. ..
  23. Lin T, Fang H. Transthoracic endoscopic sympathectomy for craniofacial hyperhidrosis: analysis of 46 cases. J Laparoendosc Adv Surg Tech A. 2000;10:243-7 pubmed
    ..We wished to investigate whether transthoracic endoscopic sympathectomy (TES) of the lower part of the stellate ganglion is efficient and safe in the treatment of craniofacial hyperhidrosis...
  24. Maki P, Rubin L, Savarese A, Drogos L, Shulman L, Banuvar S, et al. Stellate ganglion blockade and verbal memory in midlife women: Evidence from a randomized trial. Maturitas. 2016;92:123-129 pubmed publisher
    In a pilot randomized clinical trial of active stellate ganglion blockade (SGB) versus sham control, SGB significantly reduced the frequency of reported moderate to severe vasomotor symptoms (VMS) and the frequency of physiologic VMS ..
  25. Fujino Y, Fukui M, Nosaka S, Matsumoto T. [Case of radial nerve injury induced by withdrawing a catheter from the cephalic vein]. Masui. 2004;53:1032-4 pubmed
    ..Neuropathic pain in this case was quickly cured by intravenous ketamine hydrochloride and stellate ganglion block...
  26. Masliukov P, Shilkin V, Nozdrachev A, Timmermans J. Histochemical features of neurons in the cat stellate ganglion during postnatal ontogenesis. Auton Neurosci. 2003;106:84-90 pubmed
    ..distribution of NADPH-diaphorase (NADPH-d) and acetylcholinesterase (AChE) were studied in neurons of the stellate ganglion in newborn, 10-, 20-day-old, 1-, 2-, 4- and 6-month-old kittens...
  27. Moore D. Stellate ganglion block-therapy for cerebral vascular accidents. Br J Anaesth. 2006;96:666; author reply 666-7 pubmed
  28. Leftheriotis D, Flevari P, Kossyvakis C, Katsaras D, Batistaki C, Arvaniti C, et al. Acute effects of unilateral temporary stellate ganglion block on human atrial electrophysiological properties and atrial fibrillation inducibility. Heart Rhythm. 2016;13:2111-2117 pubmed publisher
    In experimental models, stellate ganglion block (SGB) reduces the induction of atrial fibrillation (AF), while data in humans are limited...
  29. Burau K, Stenull I, Huber K, Misawa H, Berse B, Unsicker K, et al. c-ret regulates cholinergic properties in mouse sympathetic neurons: evidence from mutant mice. Eur J Neurosci. 2004;20:353-62 pubmed
    ..Our data suggest that c-ret signalling is necessary for the maturation of cholinergic sympathetic neurons but dispensable for de novo induction of ChAT and VAChT expression. ..
  30. Mohan R, Choate J, Golding S, Herring N, Casadei B, Paterson D. Peripheral pre-synaptic pathway reduces the heart rate response to sympathetic activation following exercise training: role of NO. Cardiovasc Res. 2000;47:90-8 pubmed
    ..with sympathetic nerve stimulation (SNS) was investigated in the isolated guinea pig double atrial/right stellate ganglion preparation from exercise trained (6-weeks swimming, n=20) and sedentary animals (n=20)...
  31. Nguyen B, Li H, Fishbein M, Lin S, Gaudio C, Chen P, et al. Acute myocardial infarction induces bilateral stellate ganglia neural remodeling in rabbits. Cardiovasc Pathol. 2012;21:143-8 pubmed publisher
    ..01). Myocardial infarction increases serum NGF levels and induces nerve sprouting and hyperinnervation in bilateral SGs for at least 1 month after MI. The hyperinnervation includes both adrenergic axons and cholinergic axons in the SG. ..
  32. Okuda Y, Kitajima T, Ogata H. [Influence of stellate ganglion block on respiratory system]. Masui. 1995;44:981-5 pubmed
    The purpose of this study was to investigate the influence of a stellate ganglion block (SGB) or stellate ganglion electrical stimulation (SGES) on pulmonary resistance, on blood flows of the bronchial, pulmonary and common carotid ..
  33. Uchida K, Tateda T, Hino H. Novel mechanism of action hypothesized for stellate ganglion block related to melatonin. Med Hypotheses. 2002;59:446-9 pubmed
    The mechanism of action of stellate ganglion block has generally been explained by vasodilation within its sphere of innervation...
  34. Sawyer R, Turnbull D, Richmond M, Hamnegard C, Mills G. Assessment of diaphragm function after stellate ganglion block using magnetic stimulation. Anaesthesia. 2002;57:70-6 pubmed
    b>Stellate ganglion block is a procedure frequently used for the management of patients with chronic sympathetically mediated pain affecting the arm, neck or head...
  35. McNamara C, Cullen P, Rackauskas M, Kelly R, O Sullivan K, Galvin J, et al. Left cardiac sympathetic denervation: case series and technical report. Ir J Med Sci. 2017;186:607-613 pubmed publisher
    ..It involves the removal of the lower half of the stellate ganglion and T2-T4 of the sympathetic ganglia and is carried out as either a unilateral or bilateral procedure...
  36. Servant D, Logier R, Mouster Y, Goudemand M. [Heart rate variability. Applications in psychiatry]. Encephale. 2009;35:423-8 pubmed publisher
    ..Limitations of the review literature have also been considered to identify areas for future research. ..
  37. Kakuyama M, Toda H, Osawa M, Fukuda K. The bilateral effect of stellate ganglion block on the facial skin blood flow. Reg Anesth Pain Med. 2000;25:389-92 pubmed
    It is our hypothesis that stellate ganglion block increases regional blood flow on the blocked side, but does not change cardiac output, suggesting that the corresponding regional blood flow on the contralateral side may decrease, which ..
  38. Bottger E, Diehlmann K. [Selected interventional methods for the treatment of chronic pain: Part 1: peripheral nerve block and sympathetic block]. Anaesthesist. 2011;60:479-91; quiz 492 pubmed publisher
  39. Albertyn J, Barry R, Odendaal C. Cluster headache and the sympathetic nerve. Headache. 2004;44:183-5 pubmed
    ..A surgical sympathectomy removing the stellate ganglion rendered him pain-free for 15 months after which he was lost to follow-up...
  40. Bal R, Baydas G. Electrophysiological properties of octopus neurons of the cat cochlear nucleus: an in vitro study. J Assoc Res Otolaryngol. 2009;10:281-93 pubmed publisher
  41. Yokoyama K, Kishida T, Sugiyama K. Stellate ganglion block and regional cerebral blood volume and oxygenation. Can J Anaesth. 2004;51:515-6 pubmed
  42. Corell M, Wicher G, Limbach C, Kilimann M, Colman D, Fex Svenningsen A. Spatiotemporal distribution and function of N-cadherin in postnatal Schwann cells: A matter of adhesion?. J Neurosci Res. 2010;88:2338-49 pubmed publisher
    ..It may form adherents/junctions between nonmyelinating glia, which contribute to the stable tubular structure encapsulating thin caliber axons and thus stabilize the nerve structure as a whole. ..
  43. Mizuno J, Sugimoto S, Ikeda M, Kamakura T, Machida K, Kusume S. [Treatment with stellate ganglion block, continuous epidural block and ulnar nerve block of a patient with postherpetic neuralgia who developed complex regional pain syndrome (CRPS)]. Masui. 2001;50:548-51 pubmed
    ..She received right stellate ganglion block (SGB), continuous cervical epidural block and right ulnar nerve block...
  44. Ajijola O, Wisco J, Lambert H, Mahajan A, Stark E, Fishbein M, et al. Extracardiac neural remodeling in humans with cardiomyopathy. Circ Arrhythm Electrophysiol. 2012;5:1010-116 pubmed publisher
    ..These changes may be related to increased cardiac sympathetic signaling and ventricular arrhythmias. Further studies are needed to determine the electrophysiological consequences of extracardiac neuronal remodeling in humans. ..
  45. Fernandez S, Huang M, Davidson B, Knight P, Izzo J. Modulation of angiotensin II responses in sympathetic neurons by cytosolic calcium. Hypertension. 2003;41:56-63 pubmed
    ..cellular mechanisms, we studied AII-induced changes in cytosolic Ca2+ ([Ca2+]i) in primary cultures of rat stellate ganglion neurons...
  46. Altiparmak B, Uysal A, Yaşar E, Demirbilek S. [Alternative approach to autonomic instability of very severe tetanus: stellate ganglion block]. Rev Bras Anestesiol. 2018;68:209-211 pubmed publisher
    ..At the 16th day, dexmedetomidine infusion was started. At the 20th day, ultrasound guided stellate ganglion block was performed to denervate sympathetic activity...
  47. Kawada T, Yamazaki T, Akiyama T, Inagaki M, Shishido T, Zheng C, et al. Vagosympathetic interactions in ischemia-induced myocardial norepinephrine and acetylcholine release. Am J Physiol Heart Circ Physiol. 2001;280:H216-21 pubmed
    ..In contrast, the cardiac sympathetic afferent and efferent activities played little role in the ischemia-induced myocardial ACh release...
  48. Babalian A, Jacomme A, Doucet J, Ryugo D, Rouiller E. Commissural glycinergic inhibition of bushy and stellate cells in the anteroventral cochlear nucleus. Neuroreport. 2002;13:555-8 pubmed
    ..These data, together with our similar findings in other CN subdivisions, indicate that principal cells of the CN contribute to binaural interactions at earliest stages of acoustic processing. ..
  49. Giri S, Nixdorf D. Sympathetically maintained pain presenting first as temporomandibular disorder, then as parotid dysfunction. J Can Dent Assoc. 2007;73:163-7 pubmed
    ..Two years after the onset of symptoms and initiation of care, treatment with repeated stellate ganglion blocks and enteral clonidine pharmacotherapy provided adequate pain relief.
  50. Jung B, Dave A, Tan A, Gholmieh G, Zhou S, Wang D, et al. Circadian variations of stellate ganglion nerve activity in ambulatory dogs. Heart Rhythm. 2006;3:78-85 pubmed
    ..The purpose of this study was to continuously record stellate ganglion nerve activity (SGNA) in ambulatory dogs...
  51. Tong H, Nelson V. Recurrent and migratory reflex sympathetic dystrophy in children. Pediatr Rehabil. 2000;4:87-9 pubmed
    ..The first two times were refractory to conservative management and resolved with four stellate ganglion blocks. The third recurrence persisted with three stellate ganglion blocks and resolved with gabapentin.
  52. Asamoto K. [Neural circuit of the cervical sympathetic nervous system with special reference to input and output of the cervical sympathetic ganglia: relationship between spinal cord and cervical sympathetic ganglia and that between cervical sympathetic ganglia. Kaibogaku Zasshi. 2004;79:5-14 pubmed
    ..the arborization pattern of a single preganglionic axon in the superior cervical ganglion (SCG) and stellate ganglion (STG). These axons expanded in the longitudinal direction, but not for transverse direction...
  53. Chang K, Wu W, Ozcakar L. Ultrasound-Guided Interventions of the Cervical Spine and Nerves. Phys Med Rehabil Clin N Am. 2018;29:93-103 pubmed publisher
    ..scanning and guidance for cervical interventions; for example, cervical root, superficial cervical plexus, stellate ganglion, cervical medial branch, greater occipital nerve, and third occipital nerve...