Stellate Ganglion Block (SGB) for management of PTSD

March 15th, 2024
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What Is SGB?

SGB is a minimally invasive medical procedure that involves injecting anaesthetic medication into the stellate ganglion, a cluster of nerves located in the neck.

The stellate ganglion plays a crucial role in regulating various bodily functions, including pain perception, circulation, and stress responses.

How Does SGB Work?

1. Targeting Sympathetic Nerves:

  • SGB specifically targets the sympathetic nerves near the front of the neck.
  • By doing so, it interrupts the sympathetic nervous system’s activity in that region.
  • The sympathetic nervous system is responsible for the “fight-or-flight” response and contributes to stress-related symptoms.

2. Resetting the System:

  • SGB acts like a “reboot” for the sympathetic nervous system.
  • It resets the system to its pre-trauma state, similar to how a computer restarts to resolve glitches.
  • This reset may help alleviate symptoms associated with PTSD.

3. Reducing Nerve Growth Factor (NGF) Levels:

  • Some research suggests that SGB may help reduce NGF levels.
  • Elevated NGF is associated with stress-related conditions, including PTSD.
  • By modulating NGF, SGB may contribute to symptom relief.

Clinical Effectiveness and Evidence

1. Mixed Results:

  • The clinical effectiveness of SGB for treating PTSD remains a topic of debate.
  • Studies have produced mixed results, leading to ongoing research.

2. Randomized Controlled Trials (RCTs):

  • One RCT found no significant differences in PTSD symptoms between SGB and sham treatment groups.
  • Another RCT reported significantly greater improvements in PTSD symptoms, depression, anxiety, and distress for participants receiving SGB compared to sham treatment.

3. Adverse Events:

  • Adverse events related to SGB were generally mild.
  • These included injection site pain, self-resolving bradycardia, and temporary laryngeal irritation.
  • Rates of adverse events did not significantly differ between SGB and sham groups.

4. Guideline Recommendations:

  • Existing guidelines do not provide clear recommendations for or against SGB in PTSD treatment due to insufficient evidence.
  • No relevant literature or guidelines address SGB for depression or anxiety.

Considerations and Future Research

1. Short-Term Benefit:

  • SGB may offer short-term relief for some individuals with PTSD.
  • However, its long-term effects remain uncertain.

2. Quality of Life:

  • PTSD significantly impacts the quality of life.
  • Exploring alternative treatments like SGB is essential.

3. Collaboration and Research:

  • Further research is needed to understand SGB’s efficacy, safety, and long-term outcomes.
  • Studies should focus on military veterans, trauma survivors, and diverse populations.

In summary, while SGB shows promise as an adjunct treatment for PTSD, ongoing research will help establish its role in managing this challenging condition. Always consult a healthcare provider for personalized advice and consider a holistic approach to mental health.

Dr. Krishna, based in Bristol, has been performing Stellate Ganglion Blocks (SGB) in patients with PTSD for several years now. His exemplary work has garnered attention and contributed to advancing our understanding of this innovative therapeutic approach.

Here are some important aspects of Dr. Krishna’s treatment approach:

1. Patient Education and Informed Consent:

  • Dr. Krishna engages with patients, ensuring they understand the treatment thoroughly.
  • He discusses SGB in detail, explaining potential benefits and associated side effects.
  • Informed consent is a cornerstone of his practice.

2. Real-Time Ultrasound Guidance:

  • Dr. Krishna employs real-time ultrasound guidance during SGB procedures.
  • This precision ensures the accurate placement of the anaesthetic near the stellate ganglion.
  • Dr. Krishna has performed hundreds of Stellate Ganglion blocks under ultrasound guidance without any adverse events.

3. Collaboration and Holistic Approach:

  • Dr. Krishna collaborates with interdisciplinary teams, including pain psychologists and trauma therapists.
  • His holistic approach considers the overall well-being of patients, not just symptom management.

4. Long-Term Follow-Up:

  • Dr. Krishna’s commitment extends beyond initial treatments.
  • He monitors patients longitudinally, assessing the sustained impact of SGB on PTSD symptoms.

Dr. Krishna’s dedication to advancing SGB as a viable adjunct for PTSD treatment exemplifies his commitment to patient care and scientific progress. His work inspires hope for individuals struggling with PTSD and highlights the importance of innovative therapies in mental health.


  1. Effect of Stellate Ganglion Block Treatment on Posttraumatic Stress Disorder Symptoms – JAMA Psychiatry
  2. StSuccessful Use of Stellate Ganglion Block and Pulsed Radiofrequency in PTSD – NCBI
  3. Does a Stellate Ganglion Block Help PTSD Symptoms? – Healthline
  4. Stellate Ganglion Block: SGB For PTSD Treatment –
  5. Stellate Ganglion Block: What It Is, Uses, Side Effects & Risks – Cleveland Clinic

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