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Can Anesthesia Treat PTSD?

A procedure used for treating chronic pain may also help PTSD patients.

A specialized anesthetic procedure used for treating chronic pain disorders and symptoms associated with breast cancer may also be useful  in treating posttraumatic stress disorder (PTSD).  A stellate ganglion block (SGB) involves injecting a local anesthetic into the stellate ganglion
just below the subclavian artery on or above the neck of the first rib. Though the effects of the local anesthetic usually wears off after a few hours, SGB has already been found to be beneficial for a
range of pain-related and vascular medical conditions including complex regional pain syndrome and frostbite. 

Anesthesiologist Eugene Lipov has also reported positive results in treating hot flashes in women as well as PTSD.  Through his research on patients being seen at his Advanced Pain Centers clinic in Hoffman Estates, Illinois, Dr. Lipov reported anxiety relief as early as thirty minutes following an injection into the stellate gangion leading to the right hemisphere of  the brain.

One potential explanation for the effectiveness of SGB for trauma is that anesthesizing the right-sided stellate ganglion blocks right hemisphere structures of the brain which produce autonomic responses to emotional stimuli. This includes the right amygdala which has been linked to unconscious emotional memories. In a recent Psychiatric Annals report co-authored by Dr. Lipov,  SGB is shown to be a promising approach for PTSD despite the risk of potential complications including seizures or infection.  Reported improvement in  psychiatric patients receivinng SGB has been described in medical journals as far back as 1947 for disorders such as depression and schizophrenia.   Despite these findings, SGB use in psychiatry remains controversial.

The results of a clinical trial conducted at San Diego's Naval Medical Center have already been published last year in the American Journal of Psychiatry.  According to lead author Anita Hicky and her colleagues,  preliminary findings for nine military patients with chronic PTSD showed
significant improvement in five of the nine patients receiving SGB. Two other patients reported only mild improvement.  The benefit from SGB appeared to fade within one or two months after the procedure.

In commenting on SGB treatment for trauma, Naval Medical Center commander, Rear Admiral Forrest Faison said that the results appear promising though further research is ongoing.  Another case study is currently underway at Advanced Health Solutions in San Diego with 100 PTSD patients who have undergone SGB treatment.   According to Dr. Maryam Navalie,  who is also conducting the Advanced Health study, it is likely too soon to say how effective the treatment is likely to be. "We, too, don't know on average how many shots, or how long the treatment is effective, but that's part of the ongoing case study," she said in an interview with ABC 10News.

Patients receiving the treatment are far more optimistic, however.  Navy veteran Ed McGonagle, who is part of the Advanced Health study, has gone  on record as saying that SGB changed his life.  Though his anxiety previously prevented him from leaving his house or dealing with people, he insists that this is all "a thing of the past".   Whether the improvement is due to the placebo effect in action or SGB can permanently benefit PTSD patients remains to be seen.

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Romeo Vitelli, Ph.D. is a psychologist in private practice in Toronto, Canada.

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