Behavioral Health Clinicians Endorse Stellate Ganglion Block as a Valuable Intervention in the Treatment of Trauma-Related Disorders

Abstract

The stellate ganglion block (SGB) procedure has been used successfully for over 10 years to treat post-traumatic stress symptoms in thousands of US military service members, civilians, and veterans in select hospitals in Europe and North America. Primarily through targeting the autonomic nervous system, the SGB procedure serves as an invaluable adjunct to trauma-focused psychotherapy. Without published best practices for emerging therapies, clinicians are left on their own to determine how best to apply new treatments to their patient populations. The aim of this qualitative research was to compile attitudes and recommendations from therapists with expertise in using SGB for treating symptoms of post-traumatic stress disorder, so that their experiences could be disseminated widely to clinicians without SGB expertise. An 18-item survey was developed and distributed electronically to a group of behavioral health professionals of various specialties between May and June 2020. Of surveyed behavioral health clinicians with personal experience incorporating SGB into their trauma-focused psychotherapy, 95% of respondents would recommend SGB to a colleague as a useful tool for the treatment of trauma-related disorders. SGB was rated at least as useful as the most valuable interventions listed in the American Psychological Association Clinical Practice Guideline for the Treatment of Post-traumatic Stress Disorder with 100% of respondents characterizing SGB as ‘Very Beneficial’ or ‘Somewhat Beneficial’, and 0 respondents characterizing SGB as ‘Not Helpful’ or ‘Harmful’. Given the feedback from this study, behavioral health providers should consider using SGB in conjunction with standard trauma-focused care.

Interventional Mental Health: A Transdisciplinary Approach to Novel Psychiatric Care Delivery

“…For example, in addition to its role in calcium and bone metabolism, Vitamin D is critical to numerous autocrine, paracrine, and endocrine processes which modulate the hypothalamic-pituitary-adrenal axis, a complex hormonal system that is implicated in several psychiatric disorders like PTSD, MDD, and GAD [ 42 - 43 ]. Further, as the vagus nerve, a major nerve of the parasympathetic nervous system, innervates the intestinal system and produces anxiolytic or anxiogenic signals in response to certain pathogenic bacteria in the gut microbiome, evidence suggests that the gut microbiome may influence brain function [ 44 - 45 ]. Numerous studies have demonstrated that patients with depression have distinct microbiota signatures when compared with healthy controls, highlighting a potential relationship between the gut microbiome and abnormal brain function [ 46 ].…”

Stellate Ganglion Block for Psychiatric Disorders: A Systematic Review of the Clinical Research Landscape

“…Of those surveyed, 100% of clinicians characterized SGB as "Very Beneficial" or "Somewhat Beneficial," and 95% would recommend SGB to a colleague. 46 Thus, both patients and clinicians report generally positive experiences with SGB.…”

Clinical effect of perioperative stellate ganglion block on mechanical ventilation and respiratory function of elderly patients with septic shock

“…An SGB is a therapeutic strategy that can effectively regulate the stability of autonomic nervous, endocrine, and immune functions. An SGB protects the lungs through multiple pathways, such as inhibition of systemic inflammation, reduction of oxidative stress, [6] inhibition of apoptosis at the site of injury, [7] and modulation of pulmonary vasomotor activity. [8] However, no specific effects of the SGB have been reported in patients undergoing mechanical ventilation under clinical anesthesia.…”