Stellate ganglion block for treating hot flashes: A viable treatment option or sham procedure?

Thomas Guttuso
In: Maturitas · 2013 · vol. 76(3) , pp. 221–224 · doi:10.1016/j.maturitas.2013.08.001 · PMID:24021996 · W1996796076
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This review of existing studies found inconsistent results regarding stellate ganglion block efficacy for hot flashes, necessitating a randomized controlled trial with a sham control to determine its true effect.

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Abstract

Stellate ganglion block (SGB) has been used for over 70 years to treat various cervical pain syndromes. Over the past 8 years, 4 different groups have reported on SGB's effects on hot flashes from unblinded, open-label trials. Review of these studies has shown markedly disparate results in terms of the magnitude of hot flash reduction from Baseline with one trial showing a 90% reduction in hot flashes and 3 other trials showing 28-44% reductions in hot flashes. The inconsistencies in these results in addition to the known potentially large (>50%) placebo effects that can occur in randomized controlled hot flash clinical trials make it difficult to render any conclusions regarding the efficacy of SGB for hot flashes at this time. A randomized controlled trial, including a sham saline treatment arm, needs to be performed to properly assess SGB's effects on hot flashes, Methodological challenges with such a study design are addressed and several suggestions are proposed to manage these challenges.

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