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Center for Compassionate Care Innovation

National PTSD Awareness Month Spotlight: Stellate Ganglion Block, A New Treatment Option for Veterans Diagnosed with PTSD

Could an outpatient procedure for pain relief help treat anxiety and other symptoms of posttraumatic stress disorder (PTSD) for Veterans?

The VHA Center for Compassionate Care Innovation (CCI) is leading a clinical demonstration effort with the VA Long Beach Healthcare System to offer stellate ganglion block (SGB) — a widely used therapy to treat complex pain syndromes affecting the head, face, neck or arms — to a specific set of patients with severe symptoms of PTSD, such as anxiety and hypervigilance.

A doctor discussing treatment options with a patient
A doctor discussing treatment options with a patient.

To support the clinical demonstration, CCI has created an informational video and patient information sheet, and is raising awareness that the treatment is now available to Veterans in Southern California who meet the indications for treatment. So far more than 20 Veterans have been treated at the facility.

Although data varies, VA research and other studies estimate that between 10 and 30 percent of Veterans experience PTSD now or will experience it during their lifetime.

Long Beach VA Veterans receiving SGB for other health conditions report positive effects on their PTSD symptoms that last several weeks or longer.

Dr. Michael Alkire, Chief of Anesthesiology at VA Long Beach, said he hopes SGB may lessen symptoms such as hyperarousal long enough to allow Veterans to return to traditional PTSD therapies like talk therapy. The men and women who receive SGB through the support of the clinical demonstration have all tried first line treatments but have not found significant relief for their PTSD symptoms.

“If we can use this procedure to provide a month’s worth of relief for some patients, it may clear the way for further improvements using existing evidence-based PTSD therapies that previously didn’t work as well,” said Dr. Alkire

Blocking Pain Signals

During the SGB procedure, a health care provider injects a local anesthetic into a bundle of nerves located at the base of the neck. Although the exact way SGB works for PTSD is not yet known, it is thought that this temporarily “blocks” pain signals from the body to the brain and may reset the “fight or flight” response that can become over reactive in people living with PTSD. SGB is safe when given by a trained provider.

Dr. Christopher Reist, Associate Chief of Staff for Research and a staff psychiatrist at the Long Beach VA, noted that SGB has the potential to add to the range of emerging PTSD therapies, which include new medicines, acupuncture, mindfulness and other approaches.

“SGB could be a motivation for Veterans to reach out to us for help,” Reist said. He appreciated CCI for supporting VHA’s efforts to offer innovative treatments to Veterans living with chronic conditions such as PTSD.

VA established CCI to be an entry point for safe and ethical innovations that may be successful in treating a subset of the Veteran population diagnosed with certain health conditions that have not responded to evidence-based therapies. CCI focuses on these and other health concerns that may be resistant to standard treatments such as thoughts of suicide, traumatic brain injury, PTSD and chronic pain.

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Posted June 18, 2018