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@Downthelanetheycome 2693 wrote:
http://www.pjstar.com/news/x1030871530/Novel-procedure-takes-shot-at-PTSD
By ANDY KRAVETZ (akravetz@pjstar.com)
Journal Star
Posted Apr 11, 2010 @ 10:38 PM
PEORIA —
After months of savage nightmares because of his experiences in Iraq, Jason Brown of Peoria now can sleep, thanks to a novel way to treat post-traumatic stress disorder, a treatment spearheaded by a suburban Chicago doctor.The idea of using a shot to “zap” nerves in the neck has been used for years to help breast cancer survivors who suffer from hot flashes or nightmares. But Dr. Eugene Lipov, head of medicine at the Advanced Pain Centers in Hoffman Estates, thought the same thing could be a breakthrough treatment for veterans who struggle with PTSD.
Right now, the procedure, called stellate ganglion block, or SGB, isn’t approved by the government for use for PTSD, but Lipov has treated a few people with apparently positive results. He’s published that data and is in the midst of another study.
What is attractive is the convenience and the lack of medication necessary, Lipov says.
“There is no current treatment that can work quickly, but this can be done in five minutes. If the patient lies down (on the table), I know the procedure will be done correctly,” he said, unlike other avenues that require a patient to keep up with medications or to go to therapy sessions.
“Fifty percent of the people stop taking their medicine within six months, so compliance is not an issue with the block,” he said. “It doesn’t have the side effects, the fogginess and the sexual side effects of the medicines.”
For Brown, the procedure has been life changing.
…
Fortunately for Brown, his boss at Firefly was a college roommate of a doctor who was working on an experimental way to tackle PTSD. That doctor was Lipov, who had just tested his theory that SGB could be used to help someone cope with a traumatic experience and believed he might have found a potential answer to PTSD problems.
Pruning the nerves
Lipov has offered the SGB procedure for years. A person comes to his office, lies down on a table and receives a shot in the neck. The shot contains a chemical to block a bundle of nerves, the stellate ganglion, found in the neck. The nerves control blood flow to the head and upper body.
Blocking the stellate ganglion seems to “set the nerve fibers back to normal before the trauma,” Lipov said. What happens, in layman’s terms, to a person who suffers from PTSD is that there is a rapid growth of new nerves within the brain, but those new nerves tend to overload the system and cause more harm than benefit.
The block, he said, stops that growth and “prunes” the nerves back to normal.
He first tried the method on the victim of a traumatic armed robbery in 2004.
“He said things used to be going at 120 mph, and after the block, they were going at 5 mph,” Lipov said.
http://www.reddinganesthesia.com/SGB%20FAQs.htm
Redding Anesthesia Associates Medical Group
Therapeutic Pain Management Medical ClinicStellate Ganglion Injection FAQ’s
The following Frequently Asked Questions and the answers are for the Stellate Ganglion Injection. It is one of the common procedures performed in this pain clinic. The following material is given as general information only, and is not to be considered as medical advice or consultation.
What is a Stellate Ganglion Block?
Stellate Ganglion Injection is an injection of local anesthetic in the “sympathetic nerve tissue” – the nerves which are a part of Sympathetic Nervous System. The nerves are located on the either side of the voice box, in the neck.What is the purpose of it?
The injection blocks the Sympathetic Nerves. This may in turn reduce pain, swelling, color, and sweating changes in the upper extremity and may improve mobility. It is done as a part of the treatment of Reflex Sympathetic Dystrophy (RSD), Sympathetic Maintained Pain, Complex Regional Pain Syndrome, and Herpes Zoster (shingles) involving upper extremity or head and face.
How long does the injection take?
The actual injection takes only a few minutes.
What is actually injected?
The injection consists of a local anesthetic (like lidocaine or bupivacaine). Epinephrine (adrenaline) may be added to prolong the effects of the injection.
Will I be “put out” for this procedure?
No. This procedure is done under local anesthesia. Most of the patients also receive intravenous sedation and analgesia, which makes the procedure easy to tolerate. The amount of sedation given generally depends upon the patient tolerance.
How is the injection performed?
It is done either with the patient laying flat or slightly sitting up. The chin is slightly raised. The patients are monitored with EKG, blood pressure cuff and blood oxygen-monitoring device. Temperature sensing probes are also placed on your thumbs or hands. The skin in the front of the neck, next to the “voice box” is cleaned with antiseptic solution and then the injection is carried out.
What should I expect after the injection?
Immediately after the injection, you may feel your upper extremity getting warm. In addition, you may notice that your pain may be gone or quite less. You may also notice “a lump in the throat” as well as hoarse voice, droopy and red eye, and some nasal congestion on the side of the injection. You may also develop a headache.
What should I do after the procedure?
You should have a ride home. We advise the patients to take it easy for a day or so after the procedure. Perform the activities as tolerated by you. Some of the patients may go for immediate physical therapy.
Can I go to work to work the next day?
Unless there are complications, you should be able to return to your work the next day. The most common thing you may feel is soreness in the neck at the injection site.
How long the effect of the medication last?
The local anesthetic wears off in a few hours. However, the blockade of sympathetic nerves may last for many more hours. Usually, the duration of relief gets longer after each injection.
How many injections do I need to have?
If you respond to the first injection, you will be recommended for repeat injections. Usually, a series of such injections is needed to treat the problem. Some may need only 2 to 4 and some may need more that 10. The response to such injections varies from patient to patient.
What are the risks and side effects?
This procedure is safe. However, with any procedure there are risks, side effects, and possibility of complications. The most common side effect is pain – which is temporary. The other risk involves bleeding, infection, spinal block, epidural block, and injection into blood vessels and surrounding organs. Fortunately, the serious side effects and complications are uncommon.
Who should not have this injection?
If you are allergic to any of the medications to be injected, if you are on a blood thinning medication (e.g. Coumadin), or if you have an active infection going on near the injection site, you should not have the injection.
I wouldn’t mind learning how to do this.
However, I’d need an outpatient operating room.
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