ISSN: 2706-8870
Volume 7, Number 6 (2022)
Year Launched: 2016
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Combat Veteran effectively treated with Stellate Ganglion block and Hyperbaric Oxygen Therapy.

Volume 7, Issue 6, December 2022     |     PP. 312-325      |     PDF (384 K)    |     Pub. Date: November 22, 2022
DOI: 10.54647/cm32948    85 Downloads     5597 Views  

Author(s)

Emily L. Perreault, ARNP, MSN Progressive Rehabilitation Medicine, Cedar Rapids, Iowa 52402
Francesca Arese Lucini, Phd Lead Researcher at WAVi Co. 3535 So Irving St. Englewood, CO 80101
Sunny Kim, MD Progressive Rehabilitation Medicine, Cedar Rapids, Iowa 52402

Abstract
A Vietnam combat veteran with a positive history of Post Traumatic Stress Disorder was successfully treated with ultrasound guided stellate ganglion block and hyperbaric oxygen treatment. Cognitive EEG testing was done prior to the intervention and then again at three months showing improvement in cognitive functioning. The PCL-C questionnaire was utilized to assess the severity of the PTSD symptoms, which also improved post treatment. There is varying literature on the recommendations of SGB and HBOT treatments in this population and we proposed that additional research is warranted for treatment of these complex individuals to improve their quality of life thus positively affecting productivity and functionality within society.

Keywords
Stellate Ganglion Block, SGB, hyperbaric oxygen, HBOT, EEG spectrum analysis, Post traumatic stress disorder, PTSD

Cite this paper
Emily L. Perreault, Francesca Arese Lucini, Sunny Kim, Combat Veteran effectively treated with Stellate Ganglion block and Hyperbaric Oxygen Therapy. , SCIREA Journal of Clinical Medicine. Volume 7, Issue 6, December 2022 | PP. 312-325. 10.54647/cm32948

References

[ 1 ] American Psychological Association. (2017). Medications for PTSD. Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder. Retrieved April 21, 2022, from https://www.apa.org/ptsd-guideline/treatments/medications
[ 2 ] Boussi-Gross, R., Golan, H., Fishlev, G., Bechor, Y., Volkov, O., Bergan, J., Friedman, M., Hoofien, D., Shlamkovitch, N., Ben-Jacob, E., & Efrati, S. (2013). Hyperbaric oxygen therapy can improve post concussion syndrome years after mild traumatic brain injury - randomized prospective trial. PLoS ONE, 8(11). https://doi.org/10.1371/journal.pone.0079995
[ 3 ] Butt, M., Espinal, E., Aupperle, R.L., Nikulina, V., and Stewart, J.L. (2019) The Electrical Aftermath: Brain Signals of Posttraumatic Stress Disorder Filtered Through a Clinical Lens. Front. Psychiatry, 10, 368.
[ 4 ] Camporesi, E. M., & Bosco, G. (2014). Mechanisms of action of hyperbaric oxygen therapy. Undersea & hyperbaric medicine : Journal of the Undersea and Hyperbaric Medical Society, Inc, 41(3), 247–252.
[ 5 ] Center for Substance Abuse Treatment. (2014). Trauma-Informed Care in Behavioral Health Services. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); (Treatment Improvement Protocol (TIP) Series, No. 57.) Exhibit 1.3-4, DSM-5 Diagnostic Criteria for PTSD. Available from: https://www.ncbi.nlm.nih.gov/books/NBK207191/box/part1_ch3.box16/
[ 6 ] Dressler O, Schneider G, Stockmanns G, Kochs EF. Awareness and the EEG power spectrum: analysis of frequencies. British journal of anaesthesia. 2004; 93(6): 806-9.
[ 7 ] Dumermuth G, Molinari L. Spectral analysis of the EEG. Some fundamentals revisited and some open problems. Neuropsychobiology. 1987; 17(1-2): 85-99. doi: 10.1159/000118345. PMID: 3306442.
[ 8 ] Kerzner, J., Liu, H., Demchenko, I., Sussman, D., Wijeysundera, D. N., Kennedy, S. H., Ladha, K. S., & Bhat, V. (2021). Stellate Ganglion Block for Psychiatric Disorders: A Systematic Review of the Clinical Research Landscape. Chronic stress (Thousand Oaks, Calif.), 5, 24705470211055176. https://doi.org/10.1177/24705470211055176
[ 9 ] Friedman, M. J. (2007, January 31). PTSD History and Overview. Retrieved April 21, 2022, from https://www.ptsd.va.gov/professional/treat/essentials/history_ptsd.asp
[ 10 ] Gradus, J. (2007, January 31). Epidemiology of PTSD. PTSD: National Center for PTSD. Retrieved May 24, 2022, from https://www.ptsd.va.gov/professional/treat/essentials/epidemiology.asp
[ 11 ] Grandy, T.H., Werkle-Bergner, M., Chicherio, C., Schmiedek, F., Lövden, M., Lindenberger, U. (2013). Peak individual alpha frequency qualifies as a stable neurophysiological trait marker in healthy younger and older adults. Psychophysiology, 50, 570–582.
[ 12 ] Lipov, E. G., Jacobs, R., Springer, S., Candido, K. D., & Knezevic, N. N. (2022). Utility of Cervical Sympathetic Block in Treating Post-Traumatic Stress Disorder in Multiple Cohorts: A Retrospective Analysis. Pain physician, 25(1), 77–85.
[ 13 ] Lipov, E., & Ritchie, E. C. (2015). A review of the use of stellate ganglion block in the treatment of PTSD. Current Psychiatry Reports, 17(8). https://doi.org/10.1007/s11920-015-0599-4
[ 14 ] McLean B. (2015). Safety and Patient Acceptability of Stellate Ganglion Blockade as a Treatment Adjunct for Combat-Related Post-Traumatic Stress Disorder: A Quality Assurance Initiative. Cureus, 7(9), e320. https://doi.org/10.7759/cureus.320
[ 15 ] Mulvaney, S. W., Lynch, J. H., Hickey, M. J., Rahman-Rawlins, T., Schroeder, M., Kane, S., & Lipov, E. (2014). Stellate ganglion block used to treat symptoms associated with combat-related post-traumatic stress disorder: A case series of 166 patients. Military Medicine, 179(10), 1133–1140. https://doi.org/10.7205/milmed-d-14-00151
[ 16 ] National Center for PTSD. (2022). Using the PTSD Checklist for DSM IV (PCL) . Retrieved April 21, 2022, from https://www.ptsd.va.gov/professional/assessment/documents/PCL_handoutDSM4.pdf
[ 17 ] Navaie, M., Keefe, M.S., Hickey, A.H., et al. (2014). Use of stellate ganglion block for refractory post-truamatic stress disorder; A review of published cases. J Anesth Clin Res. (403)2.
[ 18 ] Parr, N. J., Anderson, J., & Veazie, S. (2021). Evidence brief: Hyperbaric oxygen therapy for traumatic brain injury and/or post-traumatic stress disorder. Evidence Brief: Hyperbaric Oxygen Therapy for Traumatic Brain Injury and/or Post-traumatic Stress Disorder. Retrieved April 21, 2022, from https://www.ncbi.nlm.nih.gov/books/NBK572533/
[ 19 ] Peterson, K., Bourne, D., Anderson, J., Mackey, K., & Helfand, M. (2017). Evidence Brief: Effectiveness of Stellate Ganglion Block for Treatment of Posttraumatic Stress Disorder (PTSD). In VA Evidence Synthesis Program Evidence Briefs. Department of Veterans Affairs (US).
[ 20 ] Uchida, K., Tateda, T., & Hino, H. (2002). Novel mechanism of action hypothesized for stellate ganglion block related to melatonin. Medical hypotheses, 59(4), 446–449. https://doi.org/10.1016/s0306-9877(02)00158-5
[ 21 ] Rae Olmsted, K. L., Bartoszek, M., Mulvaney, S., McLean, B., Turabi, A., Young, R., Kim, E., Vandermaas-Peeler, R., Morgan, J. K., Constantinescu, O., Kane, S., Nguyen, C., Hirsch, S., Munoz, B., Wallace, D., Croxford, J., Lynch, J. H., White, R., & Walters, B. B. (2020). Effect of Stellate Ganglion Block Treatment on Posttraumatic Stress Disorder Symptoms: A Randomized Clinical Trial. JAMA psychiatry, 77(2), 130–138. https://doi.org/10.1001/jamapsychiatry.2019.3474
[ 22 ] Srinivasan R, Winter WR, Ding J, Nunez PL. EEG and MEG coherence: measures of functional connectivity at distinct spatial scales of neocortical dynamics. Journal of neuroscience methods. 2007; 166(1): 41-52.