★ PTSDIY · Field Manual ★ Part V ★
Chapter 25
Stellate ganglion block
A reset for the alarm system
FM 25-SGB-201Outpatient procedure
25-1.Mission brief
A stellate ganglion block is an injection of local anesthetic into a nerve cluster in the neck that is part of the fight-or-flight system. Some people report their baseline arousal drops within minutes: less on edge, better sleep, fewer startle reactions.
25-2.Intel
A 2020 randomized trial in active-duty service members found greater PTSD improvement than a sham injection over eight weeks. Other results are mixed, and the effect's length varies. It's promising for hyperarousal, not yet a guideline treatment.
25-3.What to expect
| Step | Detail |
|---|---|
| Procedure | Guided by ultrasound or X-ray, usually 15–30 minutes, outpatient |
| Common short-term effects | Droopy eyelid, hoarse voice, warm face or arm on one side; these wear off within hours |
| Rare risks | Infection, bleeding, injection into a blood vessel; choose an experienced physician |
| Cost | Often not covered by insurance; ask about VA and military availability |
25-4.Field procedures — before you book
| 01 | Ask who performs itAn anesthesiologist or pain specialist using image guidance. |
| 02 | Ask about outcomesHow many have they done for PTSD specifically? |
| 03 | Line up therapyUse the calmer window to do trauma-focused work. |
25-5.Common faults & corrections
| ✕ | Fault: Expecting it to fix memoriesCorrection: SGB calms the alarm; it doesn't process what happened. Pair it with therapy. |
Companion episode — [IN PROGRESS]
PTSDIY · FM 25-SGB-201 · Part V25