Studies of stellate ganglion block for vasomotor symptoms in female breast cancer survivors
| Study | Treatment | Outcome measures | Results |
|---|---|---|---|
| Rahimzadeh et al, 201835 RCT N = 40 | SGB (10 mL 0.5% bupivacaine, laterality NR) vs paroxetine (7.5 mg) | Baseline to 6 weeks Hot flashes by Sloan scale Seep disturbance measured via PSQI | Hot flash scores SGB group: 42.35 to 10.50 (P < .001) Paroxetine group: 36.85 to 10.94 (P < .001) Sleep quality Trend toward better sleep noted No significant differences between SGB and paroxetine groups in hot flash and sleep quality improvement Adverse events: None; 1 mild headache |
| Othman and Zaky, 201436 RCT N = 40 | SGB (10 mL 0.5% bupivacaine, right lateral) vs pregabalin (75 mg twice daily) | Baseline to 3 months VMS frequency by self-reported daily hot fl ash diary and monthly questionnaire Hot flashes using Sloan scale | VMS Mild VMS: 28.0 to 10.0 (P = .005) Moderate VMS: 83.2 to 8.0 (P = .005) Very severe hot flashes: 51.2 to 0 (P = .005) Hot flashes Total score: 239.2 to 30.0 (P = .005) No significant differences between SGB and pregabalin Adverse events: None |
| Walega et al, 201417 RCT N = 40 | SGB (5 mL 0.5% bupivacaine, right lateral) vs sham injection | Baseline to 4–6 months Daily ambulatory sternal skin conductance monitoring and VMS diaries | VMS Reduced frequency in SGB group, event rate ratio: 0.71 (95% CI 0.64–0.99; P < .05) Reduced frequency (moderate to very severe) in SGB group, event rate ratio: 0.50 (95% CI 0.35–0.71; P < .001) Adverse events: None |
| van Gastel et al, 201332 Open-label, case-series N = 20 | SGB (7 mL 0.5% bupivacaine, right lateral) (1 excluded for lack of Horner syndrome after SGB) | Baseline to 4 weeks Hot flushes by self-reported diary and hygrometric hot flash recorder Quality of life and sleep disturbance by HFRDIS, MENQOL, ESS, and PSQI | Hot flush score Mean score decreased 34% (95% CI 18%–49%; P < .005) Quality of life Decrease in daily flush interference (HFRDIS) Sleep disturbance Decreased from 9.9 to 7.7 (P < .05) (PSQI) Adverse events: redness of conjunctiva, minimal hoarseness in first hour after SGB |
| Haest et al, 201231 Pilot and main study N = 34 | SGB (10 mL 0.25% levobupivacaine up to 3 blocks, bilateral) | Baseline to 1–24 weeks Hot flashes by self-reported diary Sleep quality assessed by self- reported diary and PSQI | Hot flash score Reduced from baseline by 64% (95% CI 49%–74%) Sleep quality Improved from OR 3.4 (95% CI 1.6–7.2) at week 1 to 4.3 (95% CI 1.9–9.8) at week 24 Adverse events: None |
| Pachman et al, 201133 Open-label, case series N = 10 (8 evaluable) | SGB (7 mL 0.5% bupivacaine, right lateral) | Baseline to 6 weeks Hot flashes by self-reported daily diary and weekly symptom questionnaires | Hot flashes Frequency: 10.1 to 5.4 Score: 17.6 to 9.8 Adverse events: None |
| Lipov et al, 200834 Open-label, pilot study N = 13 | SGB (7 mL 0.5% bupivacaine, up to 2 blocks, right lateral) | Baseline to 12 weeks Hot flashes by self-reported daily diary for Sloan hot flash score Night awakenings by PSQIS | Hot flash totals At 2 weeks: from mean 79.4 (SD 37.4) per week to 49.9 (SD 39.9) (P < .0001) At 12 weeks: very severe near zero (P < .0001) Adverse events: None |
CI = confidence interval; ESS = Epworth Sleepiness Scale; HFRDIS = Hot Flash Related Daily Interference Scale; HT = hormone therapy; MENQOL = Menopause Specific Quality of Life; NR = not reported; OR = odds ratio; PSQI = Pittsburgh Sleep Quality Index; RCT = randomized clinical trial; SD = standard deviation; SGB = stellate ganglion block; VMS = vasomotor symptoms