The Use of Stellate Ganglion Block in the Treatment of Panic/Anxiety Symptoms with Combat‐Related Post‐Traumatic Stress Disorder; Preliminary Results of Long‐Term Follow‐Up: A Case Series

Objective: Report the successful use of stellate ganglion blocks (SGBs) in two patients experiencing symptoms of post‐traumatic stress disorder (PTSD). Background: Successful treatment of PTSD with SGB has been reported previously. A similar protocol was employed at Walter Reed Army Medical Center to treat two soldiers with chronic, combat‐related PTSD. Methods: Both patients received a SGB on the right side at C6 level. The patients' PTSD symptoms were evaluated using the Post‐traumatic Stress Disorder Checklist (PCL). The PCL was administered the day prior to treatment, to establish a baseline, and the day after treatment. The PCL was also utilized during follow‐up visits to quantify the patient's symptomotology. The SGB was administered by an anesthesiologist and the psychometric tests administered by a psychologist. Results: Both patients experienced immediate, significant and durable relief as measured by the PCL (score minimum 17, maximum 85). In both instances, the pre‐treatment score suggested a PTSD diagnosis whereas the post‐treatment scores did not. One patient requested repeat treatment after 3 months, and the post‐treatment score remained below the PTSD cutoff after 7 additional months of follow‐up. Both patients discontinued all antidepressant and antipsychotic medications while maintaining their improved PCL score. Conclusion: Selective blockade of the right stellate ganglion at C6 level is a safe and minimally invasive procedure that may provide durable relief from PTSD symptoms, allowing the safe discontinuation of psychiatric medications. ?