Ipsilateral Stellate Ganglion Block Effective for Treating Shoulder Pain After Thoracotomy

Recently, Burgess et al. (1) documented the incidence and severity of ipsilateral shoulder pain after thoracotomy, a particularly difficult problem to treat. Although they examined several possible mechanisms for such pain, which included thoracic somatic and visceral as well as phrenic nerve nociception, none of their proposed explanations seemed tenable to them. The following case report demonstrates that such shoulder pain may be mediated by the sympathetic nervous system.