Videnskab

Der er forbavsende nok kun begrænset litteratur i de største psykiatriske tidsskrifter, taget i betragtning hvor effektiv SGB er i behandling af hyperarousal-symptomer hos PTSD-patienter. SGB til PTSD er et relativt nyt behandlingstilbud, og der er kommet flere og flere peer-reviewed artikler de seneste år.

Nedenunder har jeg kort beskrevet to af de klassiske artikler og angivet en referenceliste med relevante artikler.

Mulvaney SW, Lynch JH, Hickey MJ, et al. Stellate ganglion block used to treat symptoms associated with combat-related post-traumatic stress disorder: a case series of 166 patients. Mil Med. 1. oktober 2014;179:1133

Kort beskrivelse: Baseline og opfølgning af Posttraumatisk Stress Disorder Checklist Militær (PCL-M) score efter SGB (n=75). † Angiver et signifikant fald i gennemsnitlig PCL-M-score fra baseline (p<0,05)

Nyttigheden af SGB sammenlignet med standard anbefalede interventioner for PTSD

SGB = Stellatum Ganglion Blok; Meds = Medicin; NET = Narrative Exposure terapi;

EMDR = Øjenbevægelsesdesensibilisering og genbehandling; BEP = Kort eklektisk psykoterapi; PE = Langvarig eksponeringsterapi; CT = kognitiv terapi; CPT = Kognitive Processing terapi; CBT = Kognitiv adfærdsterapi. Lynch J et al. Behavioral health clinicians endorse stellate ganglion block as a valuable intervention in the treatment of trauma-related disorders. J Investig Med. 2021 Jun; 69(5): 989–993.

Kort beskrivelse: Det første studie der viser PTSD-behandleres støtte til SGB for PTSD. Baseret på en undersøgelse fra 2020 af PTSD-behandleres førstehåndserfaring med at benytte SGB til deres patienter med traume-relaterede tilstande:

1) 95 % af de adspurgte ville anbefale SGB til en kollega

2) Ingen respondenter karakteriserede SGB som "skadelig"

3) Blandt alle de psykologiske interventioner i 2017 i American Psychological Association CPG for behandling af PTSD hos voksne blev SGB fundet at være mindst lige så nyttig som de højest vurderede standardinterventioner. I betragtning af feedbacken fra denne undersøgelse bør PTSD-behandlere overveje at bruge SGB sammen med standard traumefokuseret pleje. 

REFERENCELISTE FOR STELLATUM GANGLION BLOK OG PTSD

• Treatment of Posttraumatic Stress Disorder: A State-of-the-art Review. Lisa Burback, Suzette Brémault-Phillips, Mirjam J. Nijdam, Alexander McFarlane,and Eric Vermetten. Curr Neuropharmacol. 2024 Jan 4; 22(4): 557–635

• Differential posttraumatic stress disorder symptom cluster response to stellate ganglion block: secondary analysis of a randomized controlled trial. Shannon M Blakey, Kristine L Rae Olmsted, Shawn Hirsch, Kat Asman, Dennis Wallace, Murrey G Olmsted, Russ Vandermaas-Peeler, Rhonda S Karg, Bradford B Walters. Transl Psychiatry. 2024 May 29;14(1):223.

• A pilot study of stellate ganglion block paired with exposure therapy: Feasibility and acceptability in combat veterans with posttraumatic stress disorder. Christy Capone, Erica Eaton, M Tracie Shea, Matthew Borgia, Lauren DeMoss, Krista Tocco, Keith Fragoza, Afreen Siddiqui, Psychol Trauma. 2024 Mar 14.

• The Successful Use of Bilateral 2-Level Ultrasound-Guided Stellate Ganglion Block to Improve Traumatic Brain Injury Symptoms: A Retrospective Analysis of 23 Patients.Sean W Mulvaney, James H Lynch, Kristine L Rae Olmsted, Sanjay Mahadevan, Kyle J Dineen. Mil Med, 2024 May 17: usae193.

• Sympathetic nerve blocks for posttraumatic stress disorder: an evidentiary review for future clinical trials. Prasad S, Jain N, Umar TP, Radenkov I, Ahmed SK, Sakagianni V, Kollia S, Hingora MJ, Kumari N, Akbari AR, Renemane L, Bachu A. Front Psychiatry. 2023 Dec 22;14

• Efficacy of cervical sympathetic blockade in the treatment of primary and secondary PTSD symptoms: A case series. Lipov EG, Faber JA. Heliyon. 2023 Jun 5;9(6)

• Efficacy of combined subanesthetic ketamine infusion and cervical sympathetic blockade as a symptomatic treatment of PTSD/TBI in a special forces patient with a 1-year follow-up: A case report. Lipov E, Sethi Z, Nandra G, Frueh C. Heliyon. 2023 Mar 27;9(4)

• A Review of Stellate Ganglion Block as an Adjunctive Treatment Modality. Kirkpatrick K, Khan MH, Deng Y, Shah KB. Cureus. 2023 Feb 19;15(2)

• Stellate Ganglion Block Reduces Anxiety Symptoms by Half: A Case Series of 285 Patients. Lynch JH, Mulvaney SW, Bryan CJ, Hernandez D. J Pers Med. 2023 Jun 6;13(6):958.

• Stellate ganglion block for non-pain indications: a scoping review. Feigin G, Velasco Figueroa S, Englesakis MF, D'Souza R, Hoydonckx Y, Bhatia A. Pain Med. 2023 Jul 5;24(7):775-781.

• Pearson, L., Maina, A., Compratt, T., Harden, S., Aaroe, A., Copas, W., & Thompson, L. (2023). Stellate Ganglion Block Relieves Long COVID-19 Symptoms in 86% of Patients: A Retrospective Cohort Study. Cureus. https://doi.org/10.7759/cureus.45161

• Kalava, A., Benyahia, S. A., Tico Calzada, R., & Staat, C. M. (2023). Efficacy of Stellate Ganglion Block in Treating Long-Term COVID-19-Related Olfactory and Gustatory Dysfunction: A Case Series. Cureus. https://doi.org/10.7759/cureus.40929

• Efficacy of cervical sympathetic blockade in the treatment of primary and secondary PTSD symptoms: A case series. Lipov EG, Faber JA. Heliyon. 2023 Jun 5;9(6)

• Combining a stellate ganglion block with prolonged exposure therapy for posttraumatic stress disorder: A nonrandomized clinical trial. Peterson AL, Straud CL, Young-McCaughan S, McCallin JP, Hoch M, Roux NP 3rd, Koch L, Lara-Ruiz J, Roache JD, Hein JM, Blount TH; STRONG STAR Consortium. J Trauma Stress. 2022 Dec;35(6):1801-1809.

• The Successful Use of Left-sided Stellate Ganglion Block in Patients That Fail to Respond to Right-sided Stellate Ganglion Block for the Treatment of Post-traumatic Stress Disorder Symptoms: A Retrospective Analysis of 205 Patients. Mulvaney SW, Lynch JH, Curtis KE, Ibrahim TS. Mil Med. 2022 Jul 1;187(7-8).

• Utility of Cervical Sympathetic Block in Treating Post-Traumatic Stress Disorder in Multiple Cohorts: A Retrospective Analysis. Lipov EG, Jacobs R, Springer S, Candido KD, Knezevic NN. Pain Physician. 2022 Jan;25(1):77-85.

• Behavioral health clinicians endorse stellate ganglion block as a valuable intervention in the treatment of trauma-related disorders. Lynch JH, Muench PD, Okiishi JC, Means GE, Mulvaney SW. J Investig Med. 2021 Jun;69(5):989-993.

• Behavioral health clinicians endorse stellate ganglion block as a valuable intervention in the treatment of trauma-related disorders. Lynch JH, et al. J Investig Med 2021;0:1–5.

• Effect of Stellate Ganglion Block Treatment on Posttraumatic Stress Disorder Symptoms: A Randomized Clinical Trial.Rae Olmsted, K, Bartoszek, M, Mulvaney, SW, McLean, B, Turabi, A, Young, RC, et al. JAMA Psychiatry. (2020) 77:130–8.

• Hanling, S, Hickey, AH, Lesnik, I, Hackworth, RJ, Stedje-Larsen, ET, Drastal, CA, et al. Stellate ganglion block for the treatment of posttraumatic stress disorder. Reg Anesth Pain Med. (2016) 41:494–500

• A review of the use of stellate ganglion block in the treatment of PTSD. Lipov E, Ritchie EC.Curr Psychiatry Rep. 2015 Aug;17(8):599.

• A review of the use of stellate ganglion block in the treatment of PTSD. Lipov E, Ritchie EC. Curr Psychiatry Rep. 2015 Aug;17(8):599.