“One of the biggest questions prospective participants asked in our trial was whether they could fire their weapon if they needed to,” she said. In addition to tracking the participants’ PTSD and other behavioral symptoms, the study will also periodically assess neurocognitive functioning. Rae Olmsted is currently leading a prospective cohort study that will monitor about 300 service members and veterans for 12 months following a stellate ganglion block. One of these questions involves the durability of treatment one case series of military patients suggests the effects of a stellate ganglion block diminish after one month, while a subsequent larger analysis reported they may last at least three months. Rae Olmsted said that countless questions remain regarding the benefits and risks of stellate ganglion block in patients with PTSD. In 2021, Mulvaney and Lynch co-founded the Stellate Institute, another private center that provides stellate ganglion block.) (Co-authors on the study with Rae Olmsted include Sean Mulvaney, M.D., of the Uniformed Services University of the Health Sciences and James H. “Beyond the statistics, these results were clinically significant,” Rae Olmsted said, noting that a 10-point change on the CAPS-5 is often considered a benchmark reflecting a noticeable difference. CAPS-5 scores fell on average 12.6 for the group receiving stellate ganglion blocks and 6.1 points in those receiving the sham treatment. In a separate study by Rae Olmsted, 113 active-duty service members with elevated PTSD symptoms (81% of enrollees met the DSM-5 criteria for PTSD) were randomized to receive either two stellate ganglion block injections or two sham injections, spaced two weeks apart, in combination with their regular PTSD treatments.Įight weeks after the first injection, those who received stellate ganglion blocks reported significantly lower symptoms of PTSD than those receiving sham therapy, as measured by the Clinician Administered PTSD Scale for DSM-5 (CAPS-5). … The combination of medical innovation with best practice talk therapy treatment may lead to a new standard of care for individuals suffering psychological trauma.” In the report, Lipov and colleagues wrote: “he advancement of psychological trauma care may require a paradigm shift based on the understanding that trauma is a biological injury with associated psychological changes. This retrospective analysis of over 300 patients who came to his clinic for more than 20 types of trauma between 20 found that 81% reported noticeable improvements (at least a 10-point change on the PTSD checklist) at a follow-up assessment seven to 30 days after their procedure. In 2022, Lipov published a report in the journal Pain Physician. Lipov is now the chief medical officer at the Stella Center, which offers advanced stellate ganglion block therapy, among other options, for patients paying out of pocket. He called the new approach dual sympathetic reset. Lipov said that the two injections ensure a thorough blockade. In 2012, he modified his approach by delivering two ultrasound-guided anesthetic injections to the stellate ganglion region, first at vertebrae C6 and then higher up at C3/C4. He began treating people with PTSD, including military and survivors of abuse, in 2006. He believed that by adjusting the position of the stellate ganglion block he could temporarily block communication to the brain circuits controlling the flight-or-fight response, resetting the system and reducing symptoms of PTSD. Activation of the sympathetic nervous system also triggers the “flight-or-fight” response, which can be dysregulated in people with PTSD.Įugene Lipov, M.D., a trained anesthesiologist and pain physician, was introduced to stellate ganglion block therapy in the 1980s when treating patients with neuropathic pain (such as burn pain or shingles). These nerves are a key conduit of the sympathetic nervous system, which regulates blood pressure, sweating, and pain perception. A stellate ganglion block involves an injection of anesthetic (typically Ropivacaine or Bupivacaine) next to a bundle of nerves near the base of the neck known as the stellate ganglion.
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