Safety and Patient Acceptability of Stellate Ganglion Blockade as a Treatment Adjunct for Combat-Related Post-Traumatic Stress Disorder: A Quality Assurance Initiative.
Safety and Patient Acceptability of Stellate Ganglion Blockade as a Treatment Adjunct for Combat-Related Post-Traumatic Stress Disorder: A Quality Assurance Initiative.
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DOI：
10.7759/cureus.320
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发表时间：
2015-09-10
期刊：
影响因子：
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通讯作者：
McLean B
中科院分区：
文献类型：
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作者：
McLean B
目的：通过回顾我们关于星状神经节阻滞(SGB)缓解慢性创伤后应激障碍相关症状的安全性和患者可接受性的单中心数据，实施质量保证和绩效改进项目。背景：我们的介入性疼痛管理服务一直在提供SGB疗法的试验，以帮助管理严重和复杂的治疗难治性和战斗相关的PTSD的交感调节焦虑和高觉醒症状。文献中已经有多个病例系列描述了该程序对PTSD症状管理以及图像引导程序的安全性的潜在影响。我们希望确保我们安全地执行该程序，并确保患者能够容忍和接受这一辅助治疗方案。方法：我们对过去18个月的质量保证和绩效改善数据进行了回顾，在此期间，我们进行了大约250个星状神经节阻滞来管理创伤后应激障碍症状，以检测任何潜在的并发症或意想不到的副作用。我们还分析了从一项匿名患者身份识别调查中收集的关于与该程序相关的舒适度和满意度的回应。结果：在2013年11月至2015年4月进行的250例手术中，我们没有发现任何直接的术后并发症或延迟并发症。在返回并列出的110份调查中，100%的受访患者总体上对我们的手术过程和程序感到满意，100%的患者表示他们会向朋友推荐该手术，95%的患者表示，他们愿意在几乎没有不适感和可容忍的副作用的基础上接受尽可能多的重复手术。结论：我们的质量保证和评估表明，在我们中心，对于与慢性难治性创伤后应激障碍相关的严重症状-难治性创伤后应激障碍，SGB程序是一种安全、耐受性良好和可接受的治疗辅助手段。患者满意的反应强烈暗示着很高的治疗价值，进一步的研究表明可以确定其有效性、作用持续时间和最佳治疗方案。
OBJECTIVE: To perform a quality assurance and performance improvement project through review of our single center data on the safety and patient acceptability of the stellate ganglion blockade (SGB) procedure for the relief of symptoms related to chronic post-traumatic stress disorder. BACKGROUND: Our interventional pain management service has been offering trials of SGB therapy to assist with the management of the sympathetically mediated anxiety and hyperarousal symptoms of severe and treatment-refractory combat-related PTSD. There have been multiple case series in the literature describing the potential impact of this procedure for PTSD symptom management as well as the safety of image-guided procedures. We wished to ensure that we were performing this procedure safely and that patients were tolerating and accepting of this adjunctive treatment option. METHODS: We conducted a review of our quality assurance and performance improvement data over the past 18 months during which we performed 250 stellate ganglion blocks for the management of PTSD symptoms to detect any potential complications or unanticipated side effects. We also analyzed responses from an anonymous patient de-identified survey collected regarding the comfort and satisfaction associated with the procedure. RESULTS: We did not identify any immediate post-procedural complications or delayed complications from any of the 250 procedures performed from November 2013 to April 2015. Of the 110 surveys that were returned and tabulated, 100% of the patients surveyed were overall satisfied with our process and with the procedure, 100% said they would recommend the procedure to a friend, and 95% stated that they would be willing to undergo as many repeat procedures as necessary based on little discomfort and tolerable side effects. CONCLUSION: Our quality assurance assessment suggests that in our center the SGB procedure for PTSD is a safe, well-tolerated, and acceptable treatment adjunct in the management of severe symptoms associated with chronic treatment-refractory PTSD. Patient satisfaction responses are strongly suggestive of high therapeutic value, and further studies are indicated to determine the effectiveness, duration of action, and optimal treatment regimen.