J Dent Anesth Pain Med.  2016 Sep;16(3):159-163. 10.17245/jdapm.2016.16.3.159.

Therapeutic potential of stellate ganglion block in orofacial pain: a mini review

• Jeon Y

• KMID: 2354650
• DOI: http://doi.org/10.17245/jdapm.2016.16.3.159

Abstract

Orofacial pain is a common complaint of patients that causes distress and compromises the quality of life. It has many etiologies including trauma, interventional procedures, nerve injury, varicella-zoster (shingles), tumor, and vascular and idiopathic factors. It has been demonstrated that the sympathetic nervous system is usually involved in various orofacial pain disorders such as postherpetic neuralgia, complex regional pain syndromes, and atypical facial pain. The stellate sympathetic ganglion innervates the head, neck, and upper extremity. In this review article, the effect of stellate ganglion block and its mechanism of action in orofacial pain disorders are discussed.

Keyword

Head; Orofacial; Pain; Stellate ganglion block; Sympathetic Nervous System

MeSH Terms

Complex Regional Pain Syndromes
Facial Pain*
Ganglia, Sympathetic
Head
Humans
Neck
Neuralgia, Postherpetic
Quality of Life
Stellate Ganglion*
Sympathetic Nervous System
Upper Extremity

Figure

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  Fig. 1 Stellate ganglion block using ultrasound-guided technique. Local anesthetic was injected at the C6 transverse process. CA: carotid artery.

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  Fig. 2 The sympathetic nervous system (SNS) and pain. Inflammation activates immune dendritic cells. β-2 receptors are downregulated and α-1 receptors are up-regulated on these immune cells. Following nerve injury, functional adrenoreceptors are expressed on peripheral nociceptors. Activation of the SNS increases the level of norepinephrine (NE), which activates α-adrenoreceptors on the afferent fibers, and releases nerve growth factor (NGF). NGF sensitizes peripheral nociceptors through trk A receptors.

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