A Novel Application of Stellate Ganglion Block: Preliminary Observations for the Treatment of Post-Traumatic Stress Disorder

Modulation of NGF by cortisol and the Stellate Ganglion Block – Is this the missing link between memory consolidation and PTSD?

“…Results from subsequent confirmatory trials of the effectiveness of the SGB in reducing PTSD symptoms were published by Mulvaney [23], Lipov et al (2011) [24], Hicky et al (2012) [25] and Lipov et al (2012) [26]. The specific pathways by which SGB using local anesthetic modulates NGF and NE are summarized next.…”

Post Traumatic Stress Disorder (PTSD) as an Over Activation of Sympathetic Nervous System: An Alternative View

“…Fortunately, a percutaneous procedure became available to treat PTSD. This occurred following a review of PTSD related literature, where the author realized similarity of the stellate ganglion block (SGB) and ESB due to T-2 sympathetic nerve fibers passing thorough stellate ganglion and was able to predict the effect of SGB on PTSD [18].…”

“…Clinical results have been very encouraging. The institutions were: Walter Reed National Medical Center (Mulvaney 2010), Naval Medical Center San Diego [21], Tripler Army Medical Center [22], and Advanced Pain Centers [20,23,24]. Preliminary effectiveness rate seems to be 60 to 75 % [24].…”

Stellate Ganglion Block for the Treatment of Posttraumatic Stress Disorder

“…The right side was chosen based on the technique to treat PTSD previously reported in the literature. [3][4][5][6][7][8] For participants receiving the active SGB, a 20-gauge Tuohy needle was directed percutaneously under inplane ultrasound guidance to the anterior or anterolateral edge of the longus colli muscle. After a negative "puff " test to exclude intravascular injection and negative aspiration for blood or cerebrospinal fluid, 5 mL of 0.5% ropivacaine was incrementally injected.…”

“…The technique, however, was largely forgotten as a psychiatric treatment until recent cases [3][4][5][6][7][8][9] and popular-press reports of SGB being used to treat posttraumatic stress disorder (PTSD). How an SGB mitigates symptoms in patients with PTSD is not known.…”