title: Efficacy of stellate ganglion block in the treatment of anxiety symptoms from combat-related post-traumatic stress disorder: a case series.
abstract: OBJECTIVE
  Report the efficacious use of stellate ganglion blocks (SGBs) in treating the anxiety symptoms of four patients diagnosed with combat-related post-traumatic stress disorder (PTSD) and discuss possible mechanisms of action to explain these findings.
  
  
  BACKGROUND
  Successful treatment of PTSD with SGB has been demonstrated and reported previously at Walter Reed Army Medical Center. An identical protocol was used at Tripler Army Medical Center to treat four service members diagnosed with combat-related PTSD.
  
  
  METHODS
  All patients reported received an SGB on the right side at the level of C6. The patient's PTSD symptoms were evaluated using the Post-traumatic Stress Disorder Checklist (PCL). This checklist was distributed one day before treatment and again the day following treatment. The patients were also given the PCL at subsequent follow-up visits to quantify sustained benefit.
  
  
  RESULTS
  SGB showed acute benefit for the symptoms of PTSD by markedly reduced PCL scores after the procedure. Benefits were also sustained during close outpatient follow-up.
  
  
  CONCLUSIONS
  Selective blockade of the right stellate ganglion at C6 is a minimally invasive procedure with an excellent safety profile that may provide sustained relief of PTSD symptoms. The procedure may also provide benefit for those who are resistant to psychotropic intervention.
authors.affiliation: Tripler Army Medical Center, 1 Jarrett White Road, Tripler AMC, HI 96859-5001, USA.
authors.forename: Justin
authors.initials: J
authors.lastname: Alino
authors.forename: Donald
authors.initials: D
authors.lastname: Kosatka
authors.forename: Brian
authors.initials: B
authors.lastname: McLean
authors.forename: Kenneth
authors.initials: K
authors.lastname: Hirsch
mesh_terms: D000328:Adult; D000779:Anesthetics, Local / Q000008:administration & dosage*; D001007:Anxiety / Q000209:etiology / Q000628:therapy*; D001340:Autonomic Nerve Block / Q000379:methods*; D003130:Combat Disorders / Q000150:complications*; D005500:Follow-Up Studies; D006801:Humans; D007267:Injections; D008297:Male; D008889:Military Personnel; D013233:Stellate Ganglion; D013313:Stress Disorders, Post-Traumatic / Q000150:complications*; D016896:Treatment Outcome
chemical_list: D000779:Anesthetics, Local