What it is
The stellate ganglion block (SGB) is an injection of local anesthetic into a nerve bundle in the neck. The stellate ganglion is part of the sympathetic nervous system, which may play a role in the temperature regulation signals that trigger hot flashes. Blocking it may interrupt those signals, though the exact mechanism is unclear.
How well it works
A randomized controlled trial by Walega et al. in 40 postmenopausal women found that one injection reduced moderate to very severe hot flashes by 52% over six months, more than a sham injection did (event rate ratio 0.50). Total hot flash frequency did not differ between the groups. The NAMS 2023 position statement lists SGB as a Levels II-III recommendation and notes that larger trials are needed. SGB is a common pain-management procedure that has emerged as a potential treatment for hot flashes.
Side effects and cautions
Relief can last several months, and the block can be repeated. The Walega 2014 trial followed women for six months after one injection. A temporary drooping eyelid and other signs of Horner’s syndrome are expected after the injection and show that the block has worked. Hoarseness and dizziness are also common. Serious complications such as seizures or bleeding are rare; seizures can occur if the anesthetic enters a blood vessel, and imaging guidance lowers these risks. The Walega trial excluded women with an acute infection, a bleeding disorder, or an allergy to local anesthetics.
Cost and coverage
The cited sources give no price for SGB. A 2023 review lists potentially higher cost and lack of availability among its limitations for hot flashes. In the Walega trial, a board-certified anesthesiologist performed the image-guided injections. Check our provider directory for clinics near you.
