Study of Stellate Ganglion Block as Treatment for PTSD Symptoms

Randomized, controlled trial of a treatment for posttraumatic stress disorder symptoms

United States Army Medical Research and Materiel Command

More than 7 million adults throughout the United States suffer from posttraumatic stress disorder (PTSD). Most closely associated with military combat, PTSD can occur following any traumatic event—including natural disasters, terrorist incidents, serious accidents, or physical or sexual assault. The disorder is often compounded by depression and substance abuse. Those who suffer from PTSD can also experience interpersonal and relationship difficulties as well as problems at work.

The U.S. Department of Veterans Affairs estimates that PTSD affects or has affected as much as 20 percent of those who served in the Vietnam War, Desert Storm, and Operations Iraqi Freedom and Enduring Freedom. Recent evidence suggests that PTSD is increasing among service members—rising from 7 percent of active duty service members in 2005 to 11 percent in 2008.

The Search for Effective Therapies for PTSD

The Department of Defense and other healthcare researchers continue to pursue PTSD therapies that are safe, effective, and fast-acting, with few side effects—therapies that patients will accept and adhere to.

One treatment option increasingly recommended by physicians is known as stellate ganglion block (SGB). SGB is a local anesthetic injected into the stellate ganglion, a group of nerve cells and nerves in the neck that helps regulate the body’s “fight or flight” mechanism. Performed routinely since the 1920s, the procedure has been shown to control pain in the head, neck, and arms.

Doctors and military medical centers have been performing SGB more and more to treat patients with PTSD symptoms, and, while early case reports are promising, no large-scale randomized trials have been conducted to date.

Combining Clinical Data with Patient-Centered Perspectives

Our researchers are leading the first multi-site randomized controlled trial of SGB for treatment of PTSD. The trial will determine whether the SGB procedure can decrease the severity of PTSD symptoms and whether it affects other conditions such as anxiety, suicidal thoughts, pain, and alcohol use.

Our role is to coordinate all aspects of the study at three U.S. military facilities:

  • Womack Army Medical Center in North Carolina
  • Tripler Army Medical Center in Hawaii
  • Landstuhl Regional Medical Center in Germany.

This includes developing the study protocol and its execution to measure patient health outcomes for the 8 weeks after injections.

Study participants will receive either the SGB injection or what’s referred to as a sham procedure (akin to a placebo), during which the patient receives an injection of saline near the stellate ganglion instead of the SGB medication.

We are also conducting focus groups and interviews with service members, spouses, and healthcare providers to explore how SGB is perceived in comparison to other treatments for PTSD, which should predict whether SGB could be widely accepted as an option for the many service members and veterans who suffer from PTSD.

We are enrolling active-duty service members in the study and engaging in outreach to achieve the study goal of 240 participants.

Expanding Treatment Options and Addressing the Stigma of PTSD

The study will run through 2018, gathering and analyzing clinical and qualitative data to inform recommendations for U.S. military medical centers and private practitioners who treat patients with PTSD symptoms.

If found to be effective, SGB will offer another treatment option for people suffering from PTSD—one that may be more readily accepted by military service members and veterans, for whom the stigma associated with mental healthcare is often a powerful deterrent to seeking treatment.