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Stellate ganglion blockade may be alternative to HT for vasomotor symptoms
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The use of stellate ganglion blockade may be an effective treatment for vasomotor symptoms in women who cannot or prefer not to take hormone therapy, according to researchers.
“A few small studies suggested that this treatment had potential, but this is the first study to show that this hot flash treatment really is better than placebo,” Margery Gass, MD, executive director of The North American Menopause Society, said in a press release. “The nerve blocks could prove very helpful for women with a history of breast cancer, as well as for women who prefer not to use hormones or other drugs for hot flashes.”
David R. Walega, MD, of the Northwestern University Feinberg School of Medicine, and colleagues studied 40 postmenopausal women aged 30 to 70 years with moderate-to-severe vasomotor symptoms who were randomly assigned to stellate ganglion blockade or saline solution in the sham-controlled trial.
Margery Gass
The researchers used image-guided stellate ganglion blockade with 5 mL of 0.5% bupivacaine; sham injections of saline were carried out in subcutaneous tissues in the neck, according to data.
The mean daily frequencies of total subjective vasomotor symptoms at baseline were 9.85, with 63% of vasomotor symptoms considered to be moderate-to-severe, according to researchers. The sham control group demonstrated significant placebo effects of 34% until 3 months after injections.
David R. Walega
By the fourth and sixth month, vasomotor symptoms were significantly reduced in the group assigned to stellate ganglion blockade (34%) compared with the sham control group (18%), according to data.
Overall, the researchers reported no significant group differences in vasomotor symptom frequency. However, the frequency of moderate-to-severe vasomotor symptoms were markedly less in the active group compared with the sham group (event rate ratio, 0.5; 95% CI, 0.35-0.71).
Objective vasomotor symptoms also appeared reduced in the stellate ganglion blockade group compared with the sham group (event rate ratio, 0.71; 95% CI, 0.64-0.99), researchers wrote.
Although there were no serious adverse events, researchers reported that all patients assigned to stellate ganglion blockade developed Horner syndrome immediately after injection.
Disclosure: Walega reports no relevant financial disclosures. Other researchers report financial ties to DepoMed, Noven Pharmaceuticals or Shionogi.
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