Stellate Ganglion Block for Anosmia and Dysgeusia Due to Long COVID

Chauhan, Gaurav; Upadhyay, Aman; Khanduja, Suchit; Emerick, Trent

doi:10.7759/cureus.27779

Cited by 20 publications

(51 citation statements)

References 28 publications

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“…The amount of local anesthetic used in SGB has not been standardized, with one study showing 4ml of injectate in an ultrasound-guided SGB resulting in successful Horner’s syndrome in 100% of patients while another study showing 2ml of injectate was successful in causing spread below the C7-T1 junction in 100% of patients [ 10 ]. A previous case report for SGB performed for long-COVID used 4ml of 0.25% bupivacaine [ 9 ]. Dexamethasone was added to the local anesthetic to prolong the block effect as reported in previous literature [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

“…Our patient underwent contralateral SGB 12 days after the initial injection. In prior case reports, the time between blocks has ranged between 24 and 72 hours [ 4 , 9 ]. Among patients receiving SGB for long COVID, all to date have reported further improvement after administration of the contralateral block [ 4 , 9 ].…”

Section: Discussionmentioning

confidence: 99%

“…In prior case reports, the time between blocks has ranged between 24 and 72 hours [ 4 , 9 ]. Among patients receiving SGB for long COVID, all to date have reported further improvement after administration of the contralateral block [ 4 , 9 ]. Our patient also endorsed further improved SOB and GI disturbances after the contralateral injection.…”

Section: Discussionmentioning

confidence: 99%

“…Anosmia and dysgeusia are two common sequelae of COVID-19 infections that can persist for up to 12 months from the onset of symptoms [7,8]. Although research is limited, SGB has been shown to reduce or eliminate anosmia in select groups of patients with long COVID [8,9]. The underlying mechanism is postulated to be the upregulation of cerebral blood flow (CBF), either to olfactory and gustatory centers of the brain or to peripheral chemoreceptors [7][8][9].…”

Section: Case Presentationmentioning

confidence: 99%

“…Although research is limited, SGB has been shown to reduce or eliminate anosmia in select groups of patients with long COVID [8,9]. The underlying mechanism is postulated to be the upregulation of cerebral blood flow (CBF), either to olfactory and gustatory centers of the brain or to peripheral chemoreceptors [7][8][9]. However, with the SGB effects lasting longer than that of local anesthetics, alternative mechanisms are also likely at play.…”

Section: Case Presentationmentioning

confidence: 99%

See 4 more Smart Citations

Stellate Ganglion Block for Long COVID Symptom Management: A Case Report

Khan¹,

Kirkpatrick²,

Deng³

et al. 2022

Cureus

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Stellate ganglion block (SGB) is gaining increasing acceptance as a treatment modality for various medical conditions. It works by blocking neuronal transmissions which in turn alleviates sympathetically-driven disease processes. Many of the prolonged sequelae of long COVID are thought to be mediated by dysregulation of the autonomic nervous system, and SGB is being investigated as a potential option for symptomatic management of long COVID. This case report demonstrates the efficacy of SGB in a previously healthy patient for the management of long COVID symptoms including fatigue, post-exertional malaise, shortness of breath, and gastrointestinal symptoms.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Case Presentationmentioning

confidence: 99%

Section: Case Presentationmentioning

confidence: 99%

See 3 more Smart Citations

Stellate Ganglion Block for Long COVID Symptom Management: A Case Report

Khan¹,

Kirkpatrick²,

Deng³

et al. 2022

Cureus

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Stellate ganglion block for treating post‐COVID‐19 parosmia

Naimi,

Garvey,

Chandna

et al. 2024

Int Forum Allergy Rhinol

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BackgroundPost‐COVID parosmia may be due to dysautonomia and sympathetic hyperresponsiveness, which can be attenuated by stellate ganglion block (SGB). This study evaluates SGB as a treatment for post‐COVID olfactory dysfunction (OD).MethodsRetrospective case series with prospective data of patients with post‐COVID OD undergoing unilateral (UL) or bilateral (BL) SGB. Patients completed Brief Smell Identification Tests (BSIT) (12 points maximum) and post‐procedure surveys including parosmia severity scores on a scale of 1 (absent) to 10 (severe). Scores were compared from before treatment (pre‐SGB) to after first (SGB1) or second (SGB2) treatments in overall, UL, and BL cohorts.ResultsForty‐seven patients with post‐COVID OD underwent SGB, including 23 UL and 24 BL. Twenty patients completed pre‐ and post‐SGB BSITs (eight UL and 12 BL). Twenty‐eight patients completed postprocedure surveys (11 UL and 17 BL). There were no differences in BSIT scores from pre‐SGB to post‐SGB1 or post‐SGB2 for the overall (p = 0.098), UL (p = 0.168), or BL (p = 0.230) cohorts. Parosmia severity for the overall cohort improved from pre‐SGB (8.82 ± 1.28) to post‐SGB1 (6.79 ± 2.38) and post‐SGB2 (5.41 ± 2.35), with significant differences from pre‐SGB to post‐SGB1 (p < 0.001) and pre‐SGB to post‐SGB2 (p < 0.001), but not post‐SGB1 to post‐SGB2 (p = 0.130). Number of parosmia triggers decreased for overall (p = 0.002), UL (p = 0.030) and BL (p = 0.024) cohorts. Quality of life (QOL) improved for all cohorts regarding food enjoyment, meal preparation, and socialization (p < 0.05).ConclusionSGB may improve subjective parosmia and QOL for patients with post‐COVID OD, however it may not affect odor identification. Further placebo‐controlled studies are warranted.

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Stellate Ganglion Block for the Treatment of COVID‐19‐Induced Olfactory Dysfunction: A Prospective Pilot Study

Peterson,

Miller,

Kallogjeri

et al. 2023

Otolaryngol.--head neck surg.

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ObjectiveThe objective of this study was to explore the safety and feasibility of stellate ganglion blocks (SGBs) to treat persistent COVID‐19‐induced olfactory dysfunction (OD). Secondarily, the goal was to determine effect sizes to plan a future randomized clinical trial.Study DesignProspective case series.SettingQuaternary Care Academic Medical Center.MethodsIn this single‐arm pilot trial, adult participants with a COVID‐19 diagnosis ≥ 12 months prior to enrollment with OD underwent bilateral SGBs. Subjects were followed for 1 month after completion of SGB. The primary outcome measure was the change in the Clinical Global Impression‐Improvement Scale for smell loss. Secondary outcome measures included changes in the University of Pennsylvania Smell Identification Test (UPSIT) and Olfactory Dysfunction Outcomes Rating (ODOR).ResultsTwenty participants were enrolled with a mean (SD) age of 46 (11) years and a mean (SD) duration of OD of 21 (5) months. At 1 month, 10 (50%) participants experienced at least slight subjective improvement in their OD, 11 (55%) attained a clinically meaningful improvement in smell identification using the UPSIT, and 7 (35%) achieved a clinically meaningful improvement in olfactory‐specific quality of life (QoL) measured by the ODOR. The median difference between UPSIT scores at baseline and 1 month was 6 (95% confidence interval: 3‐11), exceeding the minimal clinically important difference of 4. There were no serious adverse events.ConclusionSequential SGBs for COVID‐19‐associated OD were safe and associated with modest improvements in subjective olfaction, odor identification, and olfactory‐specific QoL. A placebo‐controlled trial is warranted to determine the efficacy of SGBs for COVID‐19‐associated OD.

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Stellate Ganglion Block for Anosmia and Dysgeusia Due to Long COVID

Cited by 20 publications

References 28 publications

Stellate Ganglion Block for Long COVID Symptom Management: A Case Report

Stellate Ganglion Block for Long COVID Symptom Management: A Case Report

Stellate ganglion block for treating post‐COVID‐19 parosmia

Stellate Ganglion Block for the Treatment of COVID‐19‐Induced Olfactory Dysfunction: A Prospective Pilot Study

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