Dual sympathetic reset VS stellate ganglion block

A stellate ganglion block is a nerve block that targets the stellate ganglion, a bundle of nerves in the neck that affects the ‘fight or flight’ response and our bodies’ response to perceived danger. Temporarily blocking this nerve bundle can act as a ‘reset’ or ‘reboot’ of the sympathetic nervous system and can provide significant, often immediate, and frequently lasting, relief for some patients struggling with symptoms of PTSD, hypervigilance, and anxiety, as well as other conditions.

Traditionally, a stellate ganglion block involves a single injection of long-acting anesthetic at this nerve cluster, located along the cervical spine at C6.

A dual sympathetic reset is a version of the stellate ganglion block that involves an injection both at C6 as well as C4. This version of the procedure was developed and popularized as a result of clinical observations and some small study evidence that performing both injections likely yields slightly better results than the traditional single injection at C6.

At Wells Medicine, although we still call the procedure a stellate ganglion block, we perform what is often called the dual sympathetic reset, with ultrasound guided block injections at both C4 and C6.

Regardless of which version of the procedure you receive, we are looking for a good sympathetic block with a display of Horner’s syndrome for a period of around 8 hours following the procedure, as well as a decrease in sympathetic activation for severe anxiety and PTSD for two to six months.