Stellate ganglion block used to treat symptoms associated with combat-related post-traumatic stress disorder: a case series of 166 patients

Mil Med. 2014 Oct;179(10):1133-40. doi: 10.7205/MILMED-D-14-00151.

Abstract

Objective: Report the successful use of stellate ganglion blocks (SGBs) in 166 active duty service members with multiple combat deployments experiencing anxiety symptoms associated with post-traumatic stress disorder (PTSD).

Background: Successful treatment of PTSD symptoms with SGB has been reported previously. This is the largest published case series evaluating SGB with a minimum of 3 months follow-up.

Methods: Following clinical interview including administration of the PTSD Checklist (PCL), 166 service members with symptoms of PTSD elected to receive a SGB. All patients received a SGB on the right side at the level of the sixth cervical vertebrae (C6). The PCL was administered the day before treatment to establish a baseline, repeated 1 week later, and then monthly out to 3 months. A positive response was considered to be an improvement in the PCL score by 10 or greater points. Follow-up PCL scores from 3 to 6 months were obtained and analyzed for 166 patients.

Results: In a military population with multiple combat deployments, over 70% of the patients treated had a clinically significant improvement in their PCL score which persisted beyond 3 to 6 months postprocedure.

Conclusion: Selective blockade of the right cervical sympathetic chain at the C6 level is a safe and minimally invasive procedure that may provide durable relief from anxiety symptoms associated with PTSD.

Publication types

  • Comparative Study
  • Multicenter Study

MeSH terms

  • Adult
  • Amides / administration & dosage
  • Anesthetics, Local / administration & dosage
  • Anxiety / psychology
  • Anxiety / therapy
  • Autonomic Nerve Block / methods*
  • Brain Injuries / etiology
  • Checklist
  • Craniocerebral Trauma / etiology
  • Explosions
  • Follow-Up Studies
  • Humans
  • Middle Aged
  • Military Personnel*
  • Retrospective Studies
  • Ropivacaine
  • Stellate Ganglion / diagnostic imaging
  • Stellate Ganglion / drug effects*
  • Stress Disorders, Post-Traumatic / psychology
  • Stress Disorders, Post-Traumatic / therapy*
  • Ultrasonography, Doppler, Color
  • Ultrasonography, Interventional / methods
  • United States

Substances

  • Amides
  • Anesthetics, Local
  • Ropivacaine