Pilot evaluation of a stellate ganglion block for the treatment of hot flashes.
OBJECTIVE
Hot flashes are a significant problem in breast cancer patients, especially because the most effective therapy, estrogen, is often contraindicated. Based on recent pilot data from a single group supporting the use of a stellate ganglion block for the treatment of hot flashes, the present pilot trial was done to further evaluate the hypothesis that a stellate ganglion block may be a safe and effective therapy for hot flashes.


METHODS
In women with breast cancer who had hot flashes, a stellate ganglion block was performed after 1 week of baseline hot flash data collection. The main efficacy measures were the changes from baseline in hot flash frequency and hot flash score during the 6th week.


RESULTS
Ten patients were enrolled between 4/23/2009 and 7/10/2009; eight patients were evaluable. After the stellate ganglion block, the mean hot flash frequency and score decreased from baseline values by over 60% during some of the post-treatment weeks. The mean hot flash frequency and score at week 6 decreased from baseline values by 44% and 45%, respectively. There were no significant adverse events clearly attributed to the stellate ganglion blocks.


CONCLUSIONS
The results of this pilot trial support that stellate ganglion blocks may be a helpful therapy for hot flashes. A prospective placebo-controlled clinical trial should be done to more definitively determine this contention.
Pachman
Deirdre R
DR
Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
Barton
Debra
D
Carns
Paul E
PE
Novotny
Paul J
PJ
Wolf
Sherry
S
Linquist
Breanna
B
Kohli
Sadhna
S
Smith
DeAnne R
DR
Loprinzi
Charles L
CL
D000328:Adult; D000368:Aged; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000627:therapeutic use*; D001340:Autonomic Nerve Block / Q000295:instrumentation / Q000379:methods*; D001943:Breast Neoplasms / Q000473:pathology*; D002045:Bupivacaine / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D019584:Hot Flashes / Q000188:drug therapy*; D006801:Humans; D008875:Middle Aged; D010865:Pilot Projects; D013233:Stellate Ganglion / Q000187:drug effects*; D011795:Surveys and Questionnaires
D000779:Anesthetics, Local; D002045:Bupivacaine