Aim of the study: To estimate the efficacy and safety of the stellate ganglion block in reducing unilateral facial pain of sympathetic origin (neuropathic pain).

Methods: thirty patients 35 years or older were included in this prospective controlled study. They had severe unilateral facial pain not responding to conventional therapy. All patients were submitted to stellate ganglion Block with 10 ml of bupivacaine 0.25% containing dexamethasone 40 mg. The pain was evaluated with VAS score: before block and then one hour, 6hrs, 24 hours, 48 hours, 72 hours, and 7 days after block.

Results: All blocks were easy to perform and were confirmed by C-arm without recorded complications. A highly significant reduction (P value <0.01) in VAS score 1 hours, and 24 hours after the blocks and significant reduction (P value <0.05) in VAS score at 48 hours After72 hours there were 8 patients with residual moderate pain (VAS 5.23±1.45) and this number was increased to 10 patients after one week requiring additional medical treatment with good response.

Conclusion: The stellate ganglion block with local anesthetic and corticosteroids in is an effective technique in relieving unilateral facial pain of sympathetic origin.