Stellate Ganglion Block: A Breakthrough Treatment for Post-Stroke Pharyngeal Dysphagia
Condition: Dysphagia; Stellate Ganglion Block
MeSH terms: Ganglion Cysts; Synovial Cyst; Deglutition Disorders
Study type: Interventional

Summary: 
      This was a multicenter randomized controlled study. 66 post-stroke patients with pharyngeal
      dysphagia were randomly allocated to the observation group (n=33) or the control group
      (n=33). Both groups were provided with comprehensive rehabilitation including routine
      rehabilitation and swallowing function training. Besides, the observation group additionally
      underwent the stellate ganglion block (SGB). At admission and after 20-day treatment, Kubota
      water swallowing test, video fluoroscopic swallowing study (VFSS), and Rosenbek
      penetration-aspiration scale (PAS) were used to assess swallowing function.
    

Detailed description: 
      Dysphagia is a frequent and potentially serious complication of stroke. However, there is no
      effective measure for the treatment of pharyngeal dysphagia in stroke patients. This study
      aims to explore the efficacy of stellate ganglion block in post-stroke pharyngeal dysphagic
      patients who received comprehensive rehabilitation. This was a multicenter randomized
      controlled study. 66 post-stroke patients with pharyngeal dysphagia were randomly allocated
      to the observation group (n=33) or the control group (n=33). Both groups were provided with
      comprehensive rehabilitation including routine rehabilitation and swallowing function
      training. Besides, the observation group additionally underwent the stellate ganglion block
      (SGB). At admission and after 20-day treatment, Kubota water swallowing test, video
      fluoroscopic swallowing study (VFSS), and Rosenbek penetration-aspiration scale (PAS) were
      used to assess swallowing function.
    

Intervention name(s): comprehensive rehabilitation; SGB
Intervention type(s): Behavioral; Drug
Intervention description(s): All the participants were provided with the comprehensive rehabilitation (routine rehabilitation and swallowing function training). The routine rehabilitation included intervention for risk factors (blood pressure, blood lipids, blood glucose, smoking and alcohol restriction, exercise, etc.) and pharmacological treatment (aspirin, statins, anticoagulants, etc.).
Regrading swallowing function training, both groups were given swallowing function training, including 1) exercises of closure of the vocal folds, pharyngeal, and laryngeal muscles exercises, and respiratory muscle strength training, for 15 min each time and twice per day. 2) isotonic／isometric swallowing exercises, supraglottic swallowing exercises, and the Mendelsohn maneuver, for 20 min each time and twice per day. 3) effortful swallowing exercises, and cough reflex training, for 10 min each time and twice per day.; the observation group was given SGB once a day, with 10 sessions as a course of treatment and each side of the body for one course. All the materials included: 1) 1.5ml of 2% Lidocaine hydrochloride injection (1ml: 0.5mg), Vitamin B12 Injection 500ug (1ml: 0.5g), the 5 ml disposable syringe and the sterile disposable dental injection needles. The specific operation procedure was as follows[16]: The operator stood at the patient&#39;s block side, and the patient was placed in the supine position, with the head leaning 45 degrees toward the contralateral side of the block side. After routine disinfection of the skin, a paratracheal approach was adopted, which was, 2.5cm above the sternoclavicular joint and 1.5cm outside the midline of the neck.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Stellate ganglion block; Pharyngeal Dysphagia; Stroke; Rehabilitation; Swallowing disorder