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Stellate Ganglion Block for the Treatment of Posttraumatic Stress Disorder: A Randomized, Double-Blind, Controlled Trial
  1. Steven R. Hanling, MD,
  2. Anita Hickey, MD,
  3. Ivan Lesnik, MD,
  4. Robert Jeremy Hackworth, MD,
  5. Eric Stedje-Larsen, MD,
  6. Carol Anne Drastal, RN, MPH and
  7. Robert N. McLay, MD, PhD
  1. From the Department of Anesthesia and Pain Medicine, Naval Medical Center-San Diego, San Diego, CA
  1. Address correspondence to: Steven R. Hanling, MD, Anesthesia/Pain Department, Naval Medical Center-San Diego, 34600 Bob Wilson Dr, San Diego, CA 92134 (e-mail: steven.r.hanling.mil{at}mail.mil; stevenhanling{at}gmail.com).

Abstract

Objective In this study, we aimed to determine if stellate ganglion block (SGB) could reduce symptoms of posttraumatic stress disorder (PTSD) in comparison with sham therapy in military service members.

Methods In a randomized trial in which both participants and assessors were blind, participants with PTSD received either an SGB or a sham procedure. Posttraumatic stress disorder symptoms were measured using the CAPS (Clinician-Administered PTSD Scale) and self-report measures of PTSD, depression, anxiety, and pain. Subjects underwent assessment before the procedure and at 1 week, 1 month, and 3 months after the procedure. Patients receiving sham injections were allowed to cross over to the treatment group, and participants who maintained criteria for PTSD were allowed to receive a second SGB treatment.

Results Posttraumatic stress disorder, anxiety, and depression scores all showed improvement across time, but there was no statistically or clinically relevant difference in outcomes between the active and control groups. Individuals who crossed over from sham treatment to SGB similarly showed no greater improvement with the SGB treatment. Improvement in CAPS was greater with a second SGB treatment than after the first treatment.

Conclusions Although previous case series have suggested that SGB offers an effective intervention for PTSD, this study did not demonstrate any appreciable difference between SGB and sham treatment on psychological or pain outcomes. Future studies should examine if differences in treatment methods or patient population could allow individuals with PTSD to benefit from SGB, but current evidence does not support widespread or indiscriminant clinical use of the procedure for PTSD.

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Footnotes

  • The authors declare no conflict of interest.

    This work was presented in part at the 31st Annual Pain Medicine meeting of the American Academy of Pain Medicine, March 19–22, 2015, in Washington, DC (podium presentation award).

    Disclaimer: The views expressed herein are those of the author(s) and do not necessarily reflect the official policy or position of the Department of Navy, Department of Defense, or the U.S. Government.

    Clinical Trial Registration: Clinicaltrials.gov NCT01629537.

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