Stellate ganglion block treats posttraumatic stress: An example of precision mental health

Lynch, James H.

doi:10.1002/brb3.1807

Cited by 10 publications

(11 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Recently, development of new treatments for psychiatric disorders has emphasized improvement in specific symptom clusters often in a trans-diagnostic manner, rather than solely by the diagnosed disorder. 45 SGB reinforces this, as certain symptoms of PTSD show more improvement than others following the procedure. Specifically, SGB has been shown to primarily decrease hyperarousal and anxiety symptoms.…”

Section: Published Studiesmentioning

confidence: 54%

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

et al. 2021

View full text Add to dashboard Cite

Stellate ganglion block (SGB) is a procedure involving the injection of a local anesthetic surrounding the stellate ganglion to inhibit sympathetic outflow. The objective of this review was to summarize existing evidence on the use of SGB in adults with psychiatric disorders. A systematic search identified 17 published studies and 4 registered clinical trials. Eighty-eight percent of published studies, including 2 randomized controlled trials (RCTs), used SGB for posttraumatic stress disorder (PTSD), although its use for schizophrenia spectrum disorders was also explored. Administration of 1 to 2 SGBs using right-sided laterality with 0.5% ropivacaine was most common. Preliminary evidence from clinical trials and case studies supports the feasibility of SGB for treating psychiatric disorders involving dysregulation of the sympathetic nervous system, although effectiveness evidence from RCTs is mixed. One RCT concluded that improvement in PTSD symptoms was significant, while the other concluded that it was nonsignificant. Improvements were noted within 5 minutes of SGB and lasted 1 month or longer. Registered clinical trials are exploring the use of SGB in new psychiatric disorders, including major depressive disorder and borderline personality disorder. More studies with larger sample sizes and alternate protocols are needed to further explore therapeutic potential of SGB for psychiatric disorders.

show abstract

Section: Published Studiesmentioning

confidence: 54%

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

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Among advanced cancer patients, factors such as an individual's spirituality, psychological stressors, and views on their mortality add layers of intricacy in addressing their pain. The benefits of SGB on depression, anxiety, complex regional pain syndrome, and post‐traumatic stress syndrome are not unanimous, nonetheless, demonstrated in smaller studies 14–17 . The sympathetic nervous system has been implicated in neuropathic pain syndromes, albeit the exact extent is unknown.…”

Section: Discussionmentioning

confidence: 99%

Stellate ganglion block to mitigate thalamic pain syndrome of an oncological origin

2023

View full text Add to dashboard Cite

BackgroundThalamic pain syndrome (TPS) is an enigmatic and rare condition. Thalamic pain syndrome is under the umbrella of central pain syndrome, which is classically associated with multiple sclerosis, spinal cord injury, postamputation, epilepsy, stroke, tumor, and Parkinson's disease. The mainstay treatment of TPS is polypharmacy. There is uncertainty about the intermediate options to manage medication‐resistant TPS before resorting to invasive, and often expensive, intracranial therapies. Stellate ganglion block (SGB) has shown promise in reducing TPS symptoms of the upper extremity and face following a thalamic ischemic event.AimsDiscuss the effect and potential utility of SGB on ipsilateral headache, facial, and upper extremity neuropathic pain due to thalamic malignancies.Materials and MethodsA review of two patient records that underwent SGB for treatment of TPS of oncologic origin.ResultsWe present two cases of the successful use of SGB for the treatment of oncologic‐related TPS for patients who had failed other conservative pharmacologic measures.DiscussionChronic pain is a complex experience that often simultaneously involves psychosocial, neuropathic, and nociceptive constituents. Among advanced cancer patients, factors such as an individual's spirituality, psychological stressors, and views on their mortality add layers of intricacy in addressing their pain. While TPS has been characterized in both stroke populations and oncologic populations, the treatment of SGB for pain relief in TPS has been limited to the stroke population. Repeated SGB worked to alleviate the ipsilateral headache, facial, and upper extremity pain in these two patients. The benefits of utilization of SGB, with the possibility of pain relief, within the thalamic malignancy population cannot be understated.ConclusionIn summary, ultrasound‐guided SGB may be considered in patients with TPS due to thalamic cancer, before pursuing more invasive intracranial surgeries to treat pain.

show abstract

“…4 17 The authors acknowledge that SGB should not be used in isolation, but rather as part of a comprehensive treatment plan involving various medical and behavioral health modalities. 22 Therefore, comparing the usefulness of SGB directly to other psychological interventions is intended to be illustrative only and not meant to recommend an 'either/ or' strategy. These comparisons should be instructive to clinicians with experience in a variety of standard PTSD psychological interventions.…”

Section: Discussionmentioning

confidence: 99%

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

Lynch

Muench²,

Okiishi

et al. 2021

Journal of Investigative Medicine

Self Cite

View full text Add to dashboard Cite

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.

show abstract

Stellate ganglion block treats posttraumatic stress: An example of precision mental health

Abstract: How to cite this article: Lynch JH. Stellate ganglion block treats posttraumatic stress: An example of precision mental health.

Cited by 10 publications

References 37 publications

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

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

Stellate ganglion block to mitigate thalamic pain syndrome of an oncological origin

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

Contact Info

Product

Resources

About