title: Stellate ganglion block used to treat symptoms associated with combat-related post-traumatic stress disorder: a case series of 166 patients.
abstract: OBJECTIVE
  Report the successful use of stellate ganglion blocks (SGBs) in 166 active duty service members with multiple combat deployments experiencing anxiety symptoms associated with post-traumatic stress disorder (PTSD).
  
  
  BACKGROUND
  Successful treatment of PTSD symptoms with SGB has been reported previously. This is the largest published case series evaluating SGB with a minimum of 3 months follow-up.
  
  
  METHODS
  Following clinical interview including administration of the PTSD Checklist (PCL), 166 service members with symptoms of PTSD elected to receive a SGB. All patients received a SGB on the right side at the level of the sixth cervical vertebrae (C6). The PCL was administered the day before treatment to establish a baseline, repeated 1 week later, and then monthly out to 3 months. A positive response was considered to be an improvement in the PCL score by 10 or greater points. Follow-up PCL scores from 3 to 6 months were obtained and analyzed for 166 patients.
  
  
  RESULTS
  In a military population with multiple combat deployments, over 70% of the patients treated had a clinically significant improvement in their PCL score which persisted beyond 3 to 6 months postprocedure.
  
  
  CONCLUSIONS
  Selective blockade of the right cervical sympathetic chain at the C6 level is a safe and minimally invasive procedure that may provide durable relief from anxiety symptoms associated with PTSD.
authors.affiliation: Consortium for Health and Military Performance, Uniformed Services University, 4301 Jones Bridge Road, Bethesda, MD 20814.
authors.forename: Sean W
authors.initials: SW
authors.lastname: Mulvaney
authors.affiliation: Stuttgart Army Health Clinic, CMR 489, Box 1742, APO, AE 09751.
authors.forename: James H
authors.initials: JH
authors.lastname: Lynch
authors.affiliation: Naval Special Warfare Command, 2000 Trident Way, Building 624, San Diego, CA 92155-5599.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Hickey
authors.affiliation: Naval Special Warfare Command, 2000 Trident Way, Building 624, San Diego, CA 92155-5599.
authors.forename: Tabassum
authors.initials: T
authors.lastname: Rahman-Rawlins
authors.affiliation: Consortium for Health and Military Performance, Uniformed Services University, 4301 Jones Bridge Road, Bethesda, MD 20814.
authors.forename: Matthew
authors.initials: M
authors.lastname: Schroeder
authors.affiliation: USASOC(A), DCS Surgeon (AOMD), 2929 Desert Storm Drive, Fort Bragg, NC 28310.
authors.forename: Shawn
authors.initials: S
authors.lastname: Kane
authors.affiliation: Advanced Pain Centers, 2260 W Higgins Road, Hoffman Estates, IL 60169.
authors.forename: Eugene
authors.initials: E
authors.lastname: Lipov
mesh_terms: D000328:Adult; D000577:Amides / Q000008:administration & dosage; D000779:Anesthetics, Local / Q000008:administration & dosage; D001007:Anxiety / Q000523:psychology / Q000628:therapy; D001340:Autonomic Nerve Block / Q000379:methods*; D001930:Brain Injuries / Q000209:etiology; D057189:Checklist; D006259:Craniocerebral Trauma / Q000209:etiology; D005107:Explosions; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D008889:Military Personnel; D012189:Retrospective Studies; D000077212:Ropivacaine; D013233:Stellate Ganglion / Q000000981:diagnostic imaging / Q000187:drug effects*; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology / Q000628:therapy*; D018615:Ultrasonography, Doppler, Color; D018084:Ultrasonography, Interventional / Q000379:methods; D014481:United States
chemical_list: D000577:Amides; D000779:Anesthetics, Local; D000077212:Ropivacaine