SGB Treatment
Stellate Ganglion Block is a minimally invasive, ultrasound-guided procedure with an 85%+ success rate in properly screened patients. No sedation. No radiation. No hospital stay.
How SGB Works
The Stellate Ganglion is part of the cervical sympathetic chain — the "fight or flight" nervous system. In PTSD, this system becomes chronically stuck in the ON position: constant hypervigilance, irritability, sleep disruption, and physical re-experiencing symptoms.
Dr. Mulvaney uses real-time ultrasound guidance to place a long-acting local anesthetic (ropivacaine) around the stellate ganglion — temporarily disengaging this chronic activation. The brain's natural neuroplasticity then enables durable change, resulting in long-term relief.
Unlike fluoroscopic (x-ray) guidance used by some providers, ultrasound visualizes nerves, blood vessels, and soft tissue directly — making the procedure safer, more precise, and more comfortable. No radiation exposure. No contrast dye.
Procedure Level
Performed at C6 and at C4 for additional benefit — at no extra cost. Dr. Mulvaney's 2020 published research demonstrated that two-level blocks provide greater benefit than single-level, and this is now standard practice at the SGB Treatment Center.
Horner's Response Grading
Dr. Mulvaney graded and published a scale for evaluating procedural success via expected temporary changes (ptosis, miosis)
Duration
The procedure itself takes minutes. Most patients are in and out the same morning.
Post-Procedure
No driving for 8 hours. Expect temporary hoarseness in ~20% of patients — this resolves within 3–6 hours and is normal.
Pricing
Most insurance plans do not cover SGB for PTSD — payment is out-of-pocket. There are no additional fees for multi-level injections. Veteran and first responder pricing is available.
Single SGB
Initial stellate ganglion block — right side, performed at C6 and C4 for additional benefit at no extra cost.
Second-Side Treatment
Left-sided SGB performed the following day (minimum 12 hours after first procedure).
Two-Day Package
Both procedures combined — ideal for traveling patients. Requires two consecutive days in Annapolis.
Pre-Appointment Requirements
We have recently simplified our pre-appointment requirements. All you have to do is call, and we will get you started.
Call 410-505-0530SGB Works Best With Talk Therapy
SGB is most effective when combined with behavioral health support. Our team maintains strong relationships with referring behavioral health professionals and can provide recommendations.
Traveling Patients
Many patients travel to Annapolis for SGB treatment. The two-day package allows bilateral treatment on consecutive days. The center can provide lodging recommendations via Visit Annapolis.
BWI Airport: 25 min north
Reagan (DCA): ~50 min
Dulles (IAD): ~90 min
Important Safety Note
Never block both sides of the neck within 12 hours — there is a theoretical risk of fatal airway blockage. This is precisely why bilateral treatment is performed over two separate days, with a minimum of 12 hours between procedures.
Ready to Schedule?
All you have to do is call, and we will get you started.