title: Efficacy of Stellate Ganglion Blockade Applied with Light Irradiation: A Systemic Review and Meta-analysis.
abstract: OBJECTIVE
  Stellate ganglion block has mostly been used to relieve symptoms of neuropathic pain; several potential complications have been reported. Noninvasive stellate ganglion block application using light irradiation (SG-LI) can be used as an alternative to conventional injection blockades. Based on the variety of application protocols among previous studies, it was needed to further identify the clinical efficacy of SG-LI in managing neuropathic pain or other disorders associated with sympathetic hyperactivity.
  
  
  METHODS
  A comprehensive search of online databases was performed to identify experimental or observational studies reporting the efficacy of SG-LI in treating patients with disorders requiring sympatholytic management. The included studies were subjected to a meta-analysis and risk-of-bias assessment.
  
  
  RESULTS
  Twenty-one experimental studies with a Physiotherapy Evidence Database score of 6/10 and 5 observational studies with a Newcastle-Ottawa scale score of 7/9 were included in the analysis. A significant effect on pain relief favoring SG-LI was identified at a standard mean difference (SMD) of -2.05 [95% confidence interval (CI), -2.49 to -1.61; P < 0.00001]. Similar effects favoring SG-LI were found in peripheral blood flow (SMD, 1.26; 95% CI, 0.26-2.25; P = 0.01) and skin temperature (SMD, 1.31; 95% CI, 0.55, 2.08; P = 0.0007).
  
  
  CONCLUSIONS
  Stellate ganglion block application using light irradiation effectively relieves pain of various etiologies and successfully induces a sympatholytic response. Stellate ganglion block application using light irradiation may be a valuable addition to the contemporary pain management armamentarium.
authors.affiliation: From the School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University (C-DL, J-YT); and Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital (C-DL, H-CC, T-HL), Center for Evidence-Based Health Care, Shuang Ho Hospital (H-CC), Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine (H-CC, T-HL), and Graduate Institute of Injury Prevention and Control (T-HL), Taipei Medical University, Taipei, Taiwan.
authors.forename: Chun-De
authors.initials: CD
authors.lastname: Liao
authors.forename: Jau-Yih
authors.initials: JY
authors.lastname: Tsauo
authors.forename: Hung-Chou
authors.initials: HC
authors.lastname: Chen
authors.forename: Tsan-Hon
authors.initials: TH
authors.lastname: Liou
mesh_terms: D001340:Autonomic Nerve Block / Q000379:methods*; D001783:Blood Flow Velocity / Q000502:physiology; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D028022:Low-Level Light Therapy / Q000379:methods*; D010147:Pain Measurement; D063868:Patient Outcome Assessment; D012881:Skin Temperature / Q000502:physiology; D013233:Stellate Ganglion; D013564:Sympathetic Nervous System / Q000502:physiology