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Comparison of the effects of stellate ganglion block and paroxetine on hot flashes and sleep disturbance in breast cancer survivors

Authors Rahimzadeh P, Imani F, Nafissi N, Ebrahimi B, Faiz SHR

Received 8 May 2018

Accepted for publication 27 July 2018

Published 26 October 2018 Volume 2018:10 Pages 4831—4837

DOI https://doi.org/10.2147/CMAR.S173511

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 2

Editor who approved publication: Professor Nakshatri


Poupak Rahimzadeh,1 Farnad Imani,1 Nahid Nafissi,2 Behzad Ebrahimi,3 Seyed Hamid Reza Faiz1

1Pain Research Center, Iran University of Medical Sciences, Tehran, Iran; 2Department of Surgery, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran; 3Department of Anesthesiology, Iran University of Medical Sciences, Tehran, Iran

Background: The incidence of menopausal symptoms, including hot flashes and sleep disturbance, caused by drug treatment is a common problem in breast cancer survivors. Considering the limitations of hormone therapy in such patients, several studies have been conducted to find alternative methods. The aim of this study was to investigate and compare the effectiveness of stellate ganglion block (SGB) with that of paroxetine, which was approved by the US Food and Drug Administration (FDA) as a medicine for the treatment of hot flashes and ensuing sleep disturbance.
Patients and methods: A total of 40 patients survived from breast cancer and complaining of these symptoms were equally assigned to two groups of 20 each. In the study group, SGB was performed successfully under sonography guidance using 10 mL of 0.5% bupivacaine, and in the control group (paroxetine), the daily administration of 7.5 mg of paroxetine was conducted for 6 weeks. The frequency and severity of hot flash attacks and sleep quality of patients were evaluated prior to the intervention and after 2, 4 and 6 weeks. The incidence of adverse events during treatment or follow-up was recorded.
Results: A significant decrease in hot flash score and sleep disturbance index (SDI) was observed in both groups. Comparison of the results showed no noticeable difference between the two groups. Two participants in the control group had discontinued medication due to gastrointestinal symptoms, and only one case of mild headache was reported in the study group.
Conclusion: SGB is as much effective as paroxetine in controlling hot flashes and sleep disturbances in breast cancer survivors and is associated with few complications.

Keywords: paroxetine, breast cancer, hot flashes, stellate ganglion block, ultrasound guidance

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