Optimizing clinical outcomes with stellate ganglion block and trauma-informed care: A review article

NeuroRehabilitation. 2024;55(3):385-396. doi: 10.3233/NRE-230236.

Abstract

Background: For decades, thousands of active-duty service members have sought treatment for trauma exposure. Stellate ganglion block (SGB) is a fast-acting nerve block documented in medical literature for nearly a century that has shown promise as a potentially life-altering treatment for post-traumatic stress (PTS).

Objective: This review aims to answer the practical questions of those who support individuals suffering from trauma: (1) SGB's safety profile (2) efficacy data (3) potential advantages and limitations, (4) a cross-cultural application example, (5) and the use of SGB in combination with talk therapy to optimize clinical outcomes.

Methods: The current body of literature, to include several large case series, meta-analyses, and a sufficiently powered randomized controlled trial, were reviewed, and presented to describe the history of SGB for emotional trauma symptoms and address the objectives of this review.

Results: Critical consideration is given to the safety and efficacy data on SGB and the evolution in safety-related technologies. Advantages such as decreased barriers to care, rapid onset, and decreased dropout and limitations such as treatment non-response, potential adverse effects, and misconceptions about the treatment are then described. Finally, the cross-cultural application of SGB is explored based on the deployment of SGB in Israel.

Conclusion: SGB is associated with level 1B evidence and a reassuring safety profile. Evolving the model of care through the combined use of effective biological treatments like SGB with trauma informed talk therapy offers a hopeful path forward for supporting those who suffer from post-traumatic stress.

Keywords: PTSD; SGB; Stellate ganglion block; combat stress disorder; military health; nerve block; post-traumatic stress disorder; veterans health.

Publication types

  • Review

MeSH terms

  • Autonomic Nerve Block* / methods
  • Humans
  • Stellate Ganglion*
  • Stress Disorders, Post-Traumatic* / therapy
  • Treatment Outcome