Ultrasound-Guided Stellate Ganglion Block in Fibromyalgia: A Randomized, Single-Center, Single-Blind, Sham-Controlled...

Area of Science:

• Pain Management
• Neurology
• Rheumatology

Background:

• Fibromyalgia is a chronic pain condition often inadequately managed by standard pharmacotherapy.
• Stellate ganglion block (SGB) is explored as an adjunctive treatment due to its sympathetic modulation effects.

Purpose of the Study:

• To evaluate the efficacy and safety of ultrasound-guided SGB as an add-on therapy for fibromyalgia patients.
• To assess SGB's impact on fibromyalgia impact and pain intensity in treatment-resistant cases.

Main Methods:

• A single-center, randomized, single-blind, sham-controlled trial involving adults meeting 2016 ACR fibromyalgia criteria on stable duloxetine.
• Participants received either ultrasound-guided SGB or a sham procedure, with two interventions one week apart.
• Primary endpoint was the change in Fibromyalgia Impact Questionnaire Revised (FIQR) total score at 1 week post-procedure.

Main Results:

• Ultrasound-guided SGB demonstrated a significant reduction in FIQR scores at 1 week (-29.9 points) and 1 month (-22.9 points) compared to sham.
• Patients receiving SGB also experienced significantly greater reductions in pain intensity (NRS) at both time points.
• No serious adverse events were reported; side effects were mild and transient.

Conclusions:

• Ultrasound-guided SGB offers clinically meaningful short-term relief for fibromyalgia impact and pain in patients refractory to duloxetine.
• The observed large effect sizes necessitate cautious interpretation due to potential unblinding and placebo effects.
• Larger, multicenter trials with extended follow-up and objective measures are recommended to confirm these findings.