Effects of stellate-ganglion block on hot flushes and night awakenings in survivors of breast cancer: a pilot study

Lipov, Eugene; Joshi, Jaydeep R; Sanders, Sarah; Wilcox, K. A.; Lipov, Sergei; Xie, Hui; Maganini, Robert; Slavin, Konstantin V.

doi:10.1016/s1470-2045(08)70131-1

Cited by 90 publications

(51 citation statements)

References 61 publications

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“…Hence it is likely that the subjects felt drowsiness in the Xe-light period, even if they tried to keep awake. On the other hand, Lipov et al 20) have reported that SGB could provide relief from sleep dysfunction. This report implies that the arousal level can be diminished by SGB.…”

Section: Discussionmentioning

confidence: 99%

Does Instability during Standing Occur just after Transcutaneous Xenon Light Irradiation around the Stellate Ganglion?

et al. 2009

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Abstract. [Purpose] This study investigated whether instability during standing occurs just after transcutaneous xenon light irradiation around the stellate ganglion.[Subjects] Thirty healthy volunteers were the subjects.[Methods] The subjects underwent two experimental sessions: 1) 10-minute xenon light irradiation around the bilateral stellate ganglions in a comfortable supine position (Xe-LISG); and 2) 10-minute rest in the same position as Xe-LISG (control). After Xe-LISG and the control, they stood up immediately and maintained quiet standing for 1 minute. The low frequency power (LF) and ratio of LF to the high frequency power (LF/HF) based on R-R intervals, and the total length (LNG) and rectangular area (REC) of the excursion of the center of foot pressure during quiet standing were examined. [Results] Although no significant changes of HF and LF/HF were observed before and after the control, HF after Xe-LISG was significantly greater than that before Xe-LISG, and LF/HF after Xe-LISG was significantly lower than that before Xe-LISG. Additionally, although no significant difference was observed between REC after Xe-LISG and that after the control, LNG after Xe-LISG was significantly longer than that after the control.[Conclusion] These results suggest that Xe-LISG causes not only parasympathetic predominance and sympathetic suppression but also instability during standing just after Xe-LISG.

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Section: Discussionmentioning

confidence: 99%

Does Instability during Standing Occur just after Transcutaneous Xenon Light Irradiation around the Stellate Ganglion?

et al. 2009

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“…Clinical application of sympathetic blockade has been expanded to patients with hormonal imbalance, psychiatric disorders, and cardiovascular diseases, 27,28 and previous publications have demonstrated that sympathetic blockade can be applied repeatedly without serious adverse effects. 29 We found that monocrotaline treatment led to a significant increase in LF/HF ratio indicating increased sympathovagal balance, whereas SGB attenuated this monocrotaline-induced autonomic balance change.…”

Section: Na Et Al Cervical Ganglion Block In Pulmonary Hypertension 313mentioning

confidence: 99%

Cervical Ganglion Block Attenuates the Progression of Pulmonary Hypertension via Nitric Oxide and Arginase Pathways

Kim²,

Ryoo³

et al. 2014

Hypertension

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Abstract-It has been recognized that the sympathetic nervous system is activated in pulmonary arterial hypertension (PAH), and abnormal sympathetic hyperactivity leads to worsening of PAH via endothelial dysfunction. The purpose of this study was to examine whether sympathetic ganglion block (SGB) can treat PAH by increasing the availability of nitric oxide (NO). PAH was induced in rats by 50 mg/kg of subcutaneous monocrotaline. After 2 weeks, daily injections of ropivacaine into the left superior cervical ganglion were repeated for 14 days (monocrotaline-SGB group). Monocrotaline group received sham SGB with saline, whereas control group received saline instead of monocrotaline. PAH was evident in monocrotaline group, with right ventricular systolic pressures (47±4 mm Hg) that were higher than those of controls (17±2 mm Hg), whereas SGB significantly attenuated monocrotalineinduced PAH (35±4 mm Hg). The right/left ventricular mass ratios exhibited similar changes to those seen with right ventricular pressures. Heart rate variability showed significantly higher sympathetic activity in the monocrotaline group. Microscopy revealed a higher proportion of muscular arteries with thicker medial walls in the monocrotaline group, which was attenuated by SGB. Monocrotaline induced arginase hyperactivity, which was in turn decreased by SGB-induced endothelial NO synthase activation. SGB restored monocrotaline-induced hypoactivity of superoxide dismutase. In conclusion, SGB could suppress PAH and the remodeling of pulmonary arteries via inactivation of arginase and reciprocal elevation of NO bioavailability, thus attenuating disproportionate hyperactivation of the have been reported to attenuate the severity of symptoms and slow the progression of cardiovascular diseases including coronary artery disease, heart failure, and arrhythmias. According to the previous reports, there is a possibility that direct sympathetic nerve blocks are effective in patients with myocardial ischemia or systemic hypertension. 17,19 Given the relationship between sympathetic nervous system hyperactivity and endothelial dysfunction in patients with PAH, blockade of sympathetic hyperactivity may improve vascular reactivity by preserving endothelial function. To date, however, there is limited amount of data on the therapeutic effects of sympathetic ganglion block (SGB) on PAH. The purpose of the present study is to assess the therapeutic effects of SGB in a monocrotaline-induced PAH rat model. In parallel, we investigated whether SGB could attenuate the changes in arginase and NO bioavailability, as well as oxidative stress caused by monocrotaline. MethodsDetailed methods about animal preparation, experimental design, SGB, heart rate variability, hemodynamic analysis, right ventricular mass, pulmonary vessel morphometry, and NO (synthase)/arginase/ cGMP/oxidative stress assay are described in the online-only Data Supplement. Results Right Ventricular Systolic Pressure and Right Ventricular/Left Ventricular Mass RatioRight ventricular systolic pr...

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“…A small study of 13 patients with a history of breast cancer treated with a stellate-ganglion block (once or twice) showed a reduction in hot flashes per week, as well as in very severe hot flashes per week over a three-month period. 5 Though standard procedural risks apply, there were no reported adverse effects from the block in this small series.…”

Section: Proceduralmentioning

confidence: 71%

Hot Flashes in Palliative Care Part 2 #262

Lefkowits¹,

Arnold²

2013

Journal of Palliative Medicine

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A thorough assessment is important to determine a treatment plan. References1. Boekhout AH, Beijnen JH, Schellens JH: Symptoms and treatment in cancer therapy-induced early menopause. Oncologist 2006;11(6):641-654. 2. Thurston RC, Joffe H: Vasomotor symptoms and menopause: Findings from the Study of Women's Health across the Nation. Obstet Gynecol Clin North Am 2001;38(3):489-501. Other references of interest Gupta P, Sturdee DW, Palin SL et al.: Menopausal symptoms in women treated for breast cancer: The prevalence and severity of symptoms and their perceived effects on quality of life. Climacteric 2006;9(1):49-58. Loprinzi CL, Barton DL: Gadgets for measuring hot flashes: Have they become the gold standard? J Support Oncol 2009; 7(4):136-137.

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Effects of stellate-ganglion block on hot flushes and night awakenings in survivors of breast cancer: a pilot study

Cited by 90 publications

References 61 publications

Does Instability during Standing Occur just after Transcutaneous Xenon Light Irradiation around the Stellate Ganglion?

Does Instability during Standing Occur just after Transcutaneous Xenon Light Irradiation around the Stellate Ganglion?

Cervical Ganglion Block Attenuates the Progression of Pulmonary Hypertension via Nitric Oxide and Arginase Pathways

Hot Flashes in Palliative Care Part 2 #262

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