Stellate ganglion block may relieve hot flashes by interrupting the sympathetic nervous system

Lipov, Eugene; Lipov, Sergei; Joshi, Jaydeep R; Santucci, V.D.; Slavin, Konstantin V.; Vigue, S.G. Beck

doi:10.1016/j.mehy.2007.01.082

Cited by 34 publications

(23 citation statements)

References 22 publications

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“…Our study showed that SGB can regulate ANS balance by inhibiting excessive SNS activity and effectively alleviate nociceptive responses, which is consistent with previous description [3, 13]. In addition, rabbits in the SGB group achieved the most improvement from HCl aspiration in our study, with no obvious effects on HR and MAP throughout the experiment.…”

Section: Discussionsupporting

confidence: 92%

“…As described previously, stellate ganglion block (SGB) is capable to accommodate ANS homeostasis through reducing SNS hyperactivity in a stress response [3, 4]. The inflammation can be inhibited by enhancement of PNS activity through activating the cholinergic anti-inflammatory pathway (CAP) via the efferent vagus nerve by specific alpha7 nAChR agonists [5], choline [6], or cholinesterase inhibitors [7] such as tetrahydroaminoacridine (THA), and electrical vagus nerve stimulation (VNS) [8].…”

Section: Introductionmentioning

confidence: 99%

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Regulating autonomic nervous system homeostasis improves pulmonary function in rabbits with acute lung injury

Liu

Tao

et al. 2017

BMC Pulm Med

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BackgroundThis study aimed to investigate the effects of regulating autonomic nervous system (ANS) homeostasis by inhibiting sympathetic hyperactivity and/or enhancing parasympathetic activity on pulmonary inflammation and functional disturbance.MethodsAn animal model of acute lung injury (ALI) was established in rabbits by an intratracheal injection of hydrochloric acid (HCl) in rabbits. Animals in control groups were received saline or HCl only, and the others received both HCl and followed treatments: vagus nerve stimulation (VNS), intravenous injection of tetrahydroaminoacridine (THA), or stellate ganglion block (SGB). The effects of different treatments on the changes in autonomic nervous system homeostasis, pulmonary and systemic inflammation, and functional disturbance were detected.ResultsSympathetic nervous activity was higher than parasympathetic nervous activity in rabbits after HCl aspiration, as demonstrated by the significant changes in the discharge frequency of cervical sympathetic/vagus trunk, and heart rate variability. VNS, THA and SGB could significantly alleviate the changes of ANS induced by HCl aspiration and improved the pulmonary function, especially for SGB treatment.ConclusionsThe disturbance of ANS homeostasis is attributed to a predominance of SNS activity. Administration of VNS, THA and SGB are capable to regulate disequilibrium of the ANS in rabbits with HCl-induced ALI and SGB is supposed to be the most effective approach.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Regulating autonomic nervous system homeostasis improves pulmonary function in rabbits with acute lung injury

Liu

Tao

et al. 2017

BMC Pulm Med

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“…Cortisol has been linked to decreases in memory, particularly in women[37, 38]. Alternatively, SGB may alter the sympathetic nervous system or brain derived neurotrophic factor[39, 40]. The duration of VMS effect in the parent trial lasted six months, far beyond the duration of sympatholysis and bupivacaine half-life.…”

Section: 0 Discussionmentioning

confidence: 99%

Stellate ganglion blockade and verbal memory in midlife women: Evidence from a randomized trial

et al. 2016

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Objectives In a pilot randomized clinical trial of active stellate ganglion blockade (SGB) versus sham control, SGB significantly reduced the frequency of reported moderate to severe vasomotor symptoms (VMS) and the frequency of physiologic VMS measured using ambulatory skin conductance monitors. Here we examine secondary effects of SGB on verbal learning and memory. Study Design In a randomized, sham-controlled study, 36 women met eligibility criteria for cognitive assessments, of whom 17 were randomized to receive fluoroscopy-guided SGB and 19 to sham control. Main Outcome Measures At baseline and three months post-treatment, women completed tests of verbal learning and memory (primary outcome) and other cognitive measures and also wore an ambulatory monitor for 24 hours to measure physiologic VMS and VMS reported in real time. Results Verbal learning improved following active SGB (p<0.05) but not sham treatment; however, the interaction between group and time was not significant (p values 0.13-0.20). Two secondary cognitive measures improved only in the sham group. Improvements in physiologic VMS correlated significantly with improvements in verbal learning (r=0.51, p<0.05). Conclusions SGB might confer benefits to memory in relation to the magnitude of improvement in physiologic VMS. Broadly these findings suggest a possible link between physiologic VMS and memory problems in midlife women.

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“…Almost everything imaginable has been tried, from sleeping on a metal-threaded cloth to all manner of herbs 38,39 and diets 40 (especially since low blood sugar, perhaps through a brain stress pathway 41 , is associated with VMS). Drugs include anti-anxiety medications to antidepressants 42 and other neuroactive interventions such as gabapentin, acupuncture 43 , clinical hypnosis 44 and stellate ganglion blockade 45 . The standard approach is estrogen-based therapy 6 -a Cochrane meta-analysis of trials…”

Section: Introductionmentioning

confidence: 99%

Progesterone for treatment of symptomatic menopausal women

Prior

2018

Climacteric

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This review's purpose is to highlight evidence that oral micronized progesterone (progesterone) is effective for hot flushes and night sweats (vasomotor symptoms, VMS), improves sleep and is likely safe in menopausal women (who are more than 1 year since last menstruation). Methods include randomized controlled clinical trials (RCT) supplemented with basic science, population and observational data as needed. The barrier to use of progesterone is lack of awareness that safety concerns with estrogenincluding 'menopausal hormone therapy' (MHT) are not applicable to progesterone. In a single 3-month RCT, progesterone (300 mg at bedtime) was effective treatment of VMS in 133 healthy menopausal women. It caused an overall 55% VMS decrease, no withdrawal-related VMS rebound and a greater VMS decrease in 46 women with !50 moderate-intense VMS/week. Progesterone is equally or more effective than estradiol in improving cardiovascular endothelial function and caused no cardiovascular safety concerns in a 3-month RCT. An 8-year prospective cohort study (E3N) in more than 80 000 menopausal women showed progesterone prevented breast cancer in estrogen-treated women. Multiple RCTs confirm that progesterone (300 mg daily at bedtime) does not cause depression and improves deep sleep. In conclusion, progesterone effectively treats VMS, improves sleep and may be the only therapy that symptomatic women, who are menopausal at a normal age and without osteoporosis, need. ARTICLE HISTORY

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Stellate ganglion block may relieve hot flashes by interrupting the sympathetic nervous system

Cited by 34 publications

References 22 publications

Regulating autonomic nervous system homeostasis improves pulmonary function in rabbits with acute lung injury

Regulating autonomic nervous system homeostasis improves pulmonary function in rabbits with acute lung injury

Stellate ganglion blockade and verbal memory in midlife women: Evidence from a randomized trial

Progesterone for treatment of symptomatic menopausal women

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