Sympathetic nerve blocks for posttraumatic stress disorder: an evidentiary review for future clinical trials DOI Creative Commons
Sakshi Prasad, Nityanand Jain, Tungki Pratama Umar

et al.

Frontiers in Psychiatry, Journal Year: 2023, Volume and Issue: 14

Published: Dec. 22, 2023

Posttraumatic stress disorder (PTSD) is a chronic resulting from exposure to traumatic events. In recent years, sympathetic nerve blocks have gained interest as an emerging treatment modality for PTSD. They been shown reduce autonomic dysfunction associated with PTSD symptoms, particularly in refractory and treatment-resistant patients. However, there limited evidence regarding the technique’s effectiveness Therefore, this scoping review was designed update summarize current literature on topic inform design of future clinical trials studies. Our 22 studies (mostly case reports series) included 1,293 patients who received blocks, primarily military service members veterans, median age 42.2 years. 0.5% Ropivacaine preferred anesthetic, right sided stellate ganglion block most commonly used technique. Relapse symptoms reported commonly, additional sessions. Most side effects were mild transient. Despite encouraging results, we remain cautious interpreting benefit technique due lack sufficient standardized trial data, heterogeneity potential bias reporting. Future should focus evaluating addressing effectiveness, safety, tolerability, indications.

Language: Английский

Stellate ganglion block in disparate treatment-resistant mental health disorders: A case series DOI Creative Commons
G. Niraj,

Varsha Karanth,

Srivastava Niraj

et al.

Scandinavian Journal of Pain, Journal Year: 2025, Volume and Issue: 25(1)

Published: Jan. 1, 2025

Abstract Objectives A significant subset of patients with mental health disorders (MHDs) fail to respond standard management and are termed as treatment-resistant. This cohort has limited options for managing their condition. Autonomic dysfunction been reported in the neurobiology MHDs including anxiety, depression, obsessive-compulsive disorder (OCD), panic disorder, bipolar (BD). Stellate ganglion block (SGB) is an emerging treatment that dampens sympathetic activity shown be benefit post-traumatic stress disorder. Methods Patients treatment-resistant disparate were reviewed by a multidisciplinary team comprising psychiatrist, clinical psychologist, pain medicine physician. offered SGB novel strategy conditions. Validated outcome measures completed at baseline, 4 weeks, 16 weeks post-intervention. Results Four heterogenous who received presented this report. resulted improvement BD, OCD alcohol addiction, opioid anxiety. Conclusion could have role MHDs.

Language: Английский

Citations

1

Stellate ganglion blockade under ultrasound-guidance and the physiological responses in the rat DOI Creative Commons

R. Tran,

Shaista Malik, Christopher Reist

et al.

Frontiers in Physiology, Journal Year: 2025, Volume and Issue: 15

Published: Jan. 10, 2025

Stellate ganglion blockade (SGB) is a practical approach to managing many clinical disorders. Ultrasound-guided SGB currently adopted as more effective and safer method in humans. Developing this technique rats would facilitate further study of application. The present examined physiological responses following ultrasound-guided Sprague-Dawley rats. Under general anesthesia, lidocaine containing Chicago blue dye (1.0%-1.5% 40-60 µL) was injected into the unilateral stellate (SG). Ptosis observed on ipsilateral right (n = 8) or left 7) side administration. No ptosis noted any controls by 0.9% normal saline injection 6) SG. Heart rate (HR) significantly decreased after administration (344 ± 32 289 47 bpm; p 0.015, pre-vs. after-injection), but not saline, HR unaltered injecting variability analysis showed that with caused decrease ratio power low-frequency over high-frequency. Respiratory rate, body temperature, conditions were unchanged all rats, regardless SGB. confirmed be distributed SG region. bleeding tissue damage evident area. Our findings suggest effectively inhibits cervicothoracic sympathetic nerves enhances heart variability, controlling are likely predominantly associated rat.

Language: Английский

Citations

0

Three-Month Durability of Bilateral Two-Level Stellate Ganglion Blocks in Patients with Generalized Anxiety Disorder: A Retrospective Analysis DOI Creative Commons
Sean W. Mulvaney,

Kyle J. Dineen,

Sanjay Mahadevan

et al.

Brain Sciences, Journal Year: 2025, Volume and Issue: 15(2), P. 188 - 188

Published: Feb. 13, 2025

Purpose: Determine if performing ultrasound-guided, bilateral, two-level cervical sympathetic chain blocks (2LCSB) (performed on subsequent days) provides durable improvement in symptoms associated with anxiety. Methods: A retrospective chart review was conducted between January 2022 and November 2024. We identified 114 patients who received 2LCSB for anxiety symptoms. Generalized Anxiety Disorder 7-Item Scale (GAD-7) outcome measure scores were collected at baseline three-months post procedure 71 males 43 females. Results: Out of patients, 99 (86.8%) showed a long-lasting their GAD-7 scores. Collected forms had average 15.52 (14.99 16.40 females), which decreased after three months to an 7.28 (6.96 7.81 females). This represents 52% Conclusions: In individuals treated 2LCSB, GAD-related improved by least 3 regardless initial severity.

Language: Английский

Citations

0

Effectiveness of Dual Sympathetic Blocks for Sympathetically Mediated Symptoms in Post-acute Sequelae of SARS-CoV-2 (PASC): An Open-Label, Non-randomized Pilot Study DOI Open Access
Serena Wang, R. James Salway,

Megan Nicklay

et al.

Cureus, Journal Year: 2025, Volume and Issue: unknown

Published: March 31, 2025

Language: Английский

Citations

0

The Successful Use of Bilateral 2-Level Ultrasound-Guided Stellate Ganglion Block to Improve Traumatic Brain Injury Symptoms: A Retrospective Analysis of 23 Patients DOI Creative Commons
Sean W. Mulvaney, James H. Lynch, Kristine Rae Olmsted

et al.

Military Medicine, Journal Year: 2024, Volume and Issue: 189(11-12), P. e2573 - e2577

Published: May 17, 2024

ABSTRACT Purpose The purpose of the study was to determine whether performing ultrasound-guided, bilateral stellate ganglion blocks (SGBs; performed on subsequent days) improved traumatic brain injury (TBI) symptoms. Methods A retrospective chart review conducted for time period between August 2022 and February 2023 identify patients who received bilateral, 2-level (C6 C4) SGBs PTSD symptoms but also had a history TBI. Neurobehavioral Symptoms Inventory (NSI) scores were collected at baseline, 1 week, month post-treatment in 14 males 9 females. Results Out 23 patients, 22 showed improvement their NSI scores. baseline average score 42.7; week 18.8; 20.1. This represents 53% month. Conclusion use may be indicated treating with concomitant diagnoses mild-to-moderate

Language: Английский

Citations

3

Optimizing clinical outcomes with stellate ganglion block and trauma-informed care: A review article DOI

Shauna Springer,

Paul Whitmer,

Morgan Steinlin

et al.

Neurorehabilitation, Journal Year: 2024, Volume and Issue: 55(3), P. 385 - 396

Published: July 12, 2024

BACKGROUND: For decades, thousands of active-duty service members have sought treatment for trauma exposure. Stellate ganglion block (SGB) is a fast-acting nerve documented in medical literature nearly century that has shown promise as potentially life-altering post-traumatic stress (PTS). OBJECTIVE: This review aims to answer the practical questions those who support individuals suffering from trauma: (1) SGB’s safety profile (2) efficacy data (3) potential advantages and limitations, (4) cross-cultural application example, (5) use SGB combination with talk therapy optimize clinical outcomes. METHODS: The current body literature, include several large case series, meta-analyses, sufficiently powered randomized controlled trial, were reviewed, presented describe history emotional symptoms address objectives this review. RESULTS: Critical consideration given on evolution safety-related technologies. Advantages such decreased barriers care, rapid onset, dropout limitations non-response, adverse effects, misconceptions about are then described. Finally, explored based deployment Israel. CONCLUSION: associated level 1B evidence reassuring profile. Evolving model care through combined effective biological treatments like informed offers hopeful path forward supporting suffer stress.

Language: Английский

Citations

1

The Effect of Bilateral, Two-Level Cervical Sympathetic Chain Blocks on Specific Symptom Clusters for Traumatic Brain Injury, Independent of Concomitant PTSD Symptoms DOI Creative Commons
Sean W. Mulvaney, James H. Lynch,

Sanjay Mahadevan

et al.

Brain Sciences, Journal Year: 2024, Volume and Issue: 14(12), P. 1193 - 1193

Published: Nov. 27, 2024

Background/Objectives: The aim of this study was to determine if performing ultrasound-guided, bilateral, two-level cervical sympathetic chain blocks (2LCSBs) (performed on subsequent days) improves symptoms associated with traumatic brain injury (TBI) that do not overlap posttraumatic stress disorder (PTSD). Methods: A retrospective chart review conducted between August 2022 and February 2023. We identified twenty patients who received bilateral 2LCSBs for PTSD anxiety also had a history TBI. Neurobehavioral Symptom Inventory (NSI) scores were collected at baseline, one week, month post treatment in 13 males 7 females. sub-analysis the first ten questions NSI, which we as overlapping or symptoms, generated an NSI sub-score. Results: Out 20 patients, all showed improvement their sub-scores. sub-scores baseline average 15.45 (on 40-point scale); score week 8.30; 7.80. This represents 49.51% TBI did month. Conclusions: use may be helpful treating TBI, regardless presence comorbid symptoms.

Language: Английский

Citations

1

Differential posttraumatic stress disorder symptom cluster response to stellate ganglion block: secondary analysis of a randomized controlled trial DOI Creative Commons
Shannon M. Blakey, Kristine Rae Olmsted, Shawn Hirsch

et al.

Translational Psychiatry, Journal Year: 2024, Volume and Issue: 14(1)

Published: May 29, 2024

Abstract Empirically supported treatments for posttraumatic stress disorder (PTSD) exist, but research suggests these therapies are less effective, acceptable, and feasible to deliver active duty service members (SMs) compared civilians. Stellate ganglion block (SGB) procedure, in which a local anesthetic is injected around the cervical sympathetic chain or stellate temporarily inhibit nervous activity, gaining popularity as an alternative PTSD treatment military settings. However, it unknown whether certain symptoms more responsive SGB than others. The current study involved secondary analysis of data collected from previous randomized controlled trial sham (normal saline) injection ( N = 113 SMs). were assessed via clinical interview self-report at baseline 8 weeks post-SGB sham. Logistic regression analyses showed that marked alterations arousal reactivity symptom cluster demonstrated greatest severity reductions after SGB, relative reexperiencing also pronounced response clinician-rated not self-reported outcomes. Post-hoc item-level suggested findings driven by hypervigilance, concentration difficulties, sleep disturbance, whereas physiological reactions trauma cues, emotional intrusions. Our align with burgeoning literature positioning potential novel adjunctive treatment. Results could guide future hypothesis-driven on mediators therapeutic change during SMs.

Language: Английский

Citations

0

Clinical efficacy of high-voltage pulsed radiofrequency combined with stellate ganglion block in the acute phase of thoracic and dorsal herpes zoster neuralgia under dual guidance of ultrasound and C-arm DOI

Yong Sun,

Xiaoxue Zhao,

Fucheng Dai

et al.

Journal of Clinical Neuroscience, Journal Year: 2024, Volume and Issue: 126, P. 194 - 201

Published: June 27, 2024

Language: Английский

Citations

0

The Successful Use of Bilateral 2-level Ultrasound-guided Stellate Ganglion Block to Improve Traumatic Brain Injury Symptoms: A Retrospective Analysis of 23 Patients DOI
Sean W. Mulvaney

Military Medicine, Journal Year: 2024, Volume and Issue: 189(9-10), P. 257 - 258

Published: July 13, 2024

Language: Английский

Citations

0