Stellate Ganglion Blocks should be done via fluoroscopy. Many docs do them blind--which will be less effective and more likely to have side effects. There are people that literally have hundreds of SGB without spread, then again some people are very susceptible to spread. YOU have to know your body. IMO the surgery without a block is more likely to cause spread, than surgery with a block.

Even IV's in a my "good" limb are always scary... Lidocaine patches applied soon after has helped me from thwarting the slide into spread.

If you're able to tolerate a light massage after the block/surgery, that might help as well. http://www.rsdrx.com/massage_therapy.htm Even if it's just to the area of the block site.

You asked about stage 4. Staging is no longer used by experts within the RSD field. The last few paragraphs in this link explain why. http://www.crpsadvisory.com/crpsa_fo...l#.UB2hT3t5nTo