Rahimzadeh Poupak, Imani Farnad, Nafissi Nahid, Ebrahimi Behzad, Faiz Seyed Hamid Reza
Pain Research Center, Iran University of Medical Sciences, Tehran, Iran,
Department of Surgery, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Cancer Manag Res. 2018 Oct 26;10:4831-4837. doi: 10.2147/CMAR.S173511. eCollection 2018.
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.
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.
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.
SGB is as much effective as paroxetine in controlling hot flashes and sleep disturbances in breast cancer survivors and is associated with few complications.
药物治疗引起的更年期症状，包括潮热和睡眠障碍，在乳腺癌幸存者中是一个常见问题。考虑到此类患者激素治疗的局限性，已开展多项研究以寻找替代方法。本研究的目的是调查并比较星状神经节阻滞（SGB）与帕罗西汀的有效性，帕罗西汀已被美国食品药品监督管理局（FDA）批准用于治疗潮热及随之而来的睡眠障碍。
共有40名乳腺癌幸存者且有上述症状的患者被平均分为两组，每组20人。研究组在超声引导下使用10毫升0.5%布比卡因成功进行星状神经节阻滞，对照组（帕罗西汀组）每日服用7.5毫克帕罗西汀，持续6周。在干预前以及干预后2周、4周和6周评估患者潮热发作的频率和严重程度以及睡眠质量。记录治疗或随访期间不良事件的发生率。
两组的潮热评分和睡眠障碍指数（SDI）均显著降低。结果比较显示两组之间无明显差异。对照组有两名参与者因胃肠道症状停药，研究组仅报告1例轻度头痛。
在控制乳腺癌幸存者的潮热和睡眠障碍方面，星状神经节阻滞与帕罗西汀同样有效，且并发症较少。
