A block that is performed under fluoroscopy to determine if there is damage to the sympathetic nerve chain and if it is the source of the patient's arm pain. This is primarily a diagnostic block but it may provide pain relief in excess of the duration of the anesthetic. This procedure is helpful in treating complex regional pain syndrome/reflex sympathetic dystrophy.
A local skin anesthetic is given near the base of the neck on the affected side. A needle is inserted by the anesthesiologist near the transverse process of the cervical spine (usually at the cervical-6 level). A sterile tubing is attached to the needle and anesthetic medication is slowly injected through the tubing.
It takes less than thirty minutes for the procedure followed by evaluation and recovery for several hours.
The patient may note increased warmth and redness of the painful arm during and after the injection. The patient can expect hoarseness of their voice, redness of the eye, drooping of the eyelid and pupillary constriction for four to eight hours after the injection. Pain relief may be noted immediately. Duration of relief is variable. The patient must assess their pain relief over the first three to four hours after the injection and report this to the physician.