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Stress Disorders, Post-TraumaticPhase 2NCT05889741

Combining Stellate Ganglion Block With Prolonged Exposure for PTSD

A Phase 2 study testing Ropivacaine injection and Normal saline in people with Stress Disorders, Post-Traumatic, run by The University of Texas Health Science Center at San Antonio at 2 sites in United States.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

The goal of this clinical trial is to compare the combination of Massed Prolonged Exposure (PE); a behavioral therapy for PTSD) and a stellate ganglion block (SGB; an injection of a local anesthetic into the front of the neck) with Massed Prolonged Exposure and a sham injection in a sample of military service members… Read more about this study

Who is it for?
Ages 18 to 65 yearsHealthy volunteers can take part
Conditions the study is for
Stress Disorders, Post-Traumatic
What is being tested?
Ropivacaine injection and Normal saline
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
140 participants
Where
2 sitesUnited States
Study dates
26 Feb 2024to 31 Aug 2027
Phase
Phase 2
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 65 years
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Active duty and retired military service members ages 18-65 years
  • PTSD diagnosis as assessed by Clinician-Administered Posttraumatic Stress Scale
  • Able to speak and read English (due to standardization of outcome measures)
  • Defense Enrollment Eligibility Reporting System (DEERS)-eligible to receive care at a military treatment facility (MTF) where the stellate ganglion block will be placed.

Who cannot join

  • Current suicidal ideation severe enough to warrant immediate attention (as determined by the Depressive Symptoms Index - Suicidality Subscale and the Self-Injurious Thoughts and Behaviors Interview short form) and corroborated by a clinical risk assessment by a credentialed provider.
  • Current manic episode or psychotic symptoms requiring immediate stabilization or hospitalization (as determined by clinical judgment)
  • Symptoms of moderate to severe substance use (to include alcohol) warranting immediate intervention based on clinical judgment.
  • Other psychiatric disorders severe enough to warrant designation as the primary disorder as determined by clinician judgment
  • Pregnancy or breastfeeding
  • Current anticoagulant use
Show all 16Show fewer
  • History of bleeding disorder
  • Infection or mass at injection site
  • Myocardial infarction within 6 months of procedure
  • Pathologic bradycardia or irregularities of heart rate or rhythm
  • Symptomatic hypotension
  • Phrenic or laryngeal nerve palsy
  • History of glaucoma
  • Uncontrolled seizure disorder
  • History of allergy to local anesthetics
  • Current use of Class III antiarrhythmics

Trial locations and contacts

2 sites in 1 country. Contact the study team or a site near you to ask about taking part.

United States2 sites, 2 recruiting
  • Carl R. Darnall Army Medical Center

    Fort Hood, Texas, 76544

    Paul Fowler, 726-225-5520, fowlerp@uthscsa.edu

    Caleb Dickinson, DO

    Recruiting
  • University of Texas Health Science Center at San Antonio

    San Antonio, Texas, 78229

    Amanda Flores, 210-562-6726, floresa13@uthscsa.edu

    Alan Peterson, PhD

    Recruiting

Other trials in United States

About this study

Official title: Combining Stellate Ganglion Block With Prolonged Exposure for PTSD: A Randomized Clinical Trial

The goal of this clinical trial is to compare the combination of Massed Prolonged Exposure (PE); a behavioral therapy for PTSD) and a stellate ganglion block (SGB; an injection of a local anesthetic into the front of the neck) with Massed Prolonged Exposure and a sham injection in a sample of military service members or retirees with PTSD. The main questions it aims to answer are: (1) Does the addition of an SGB improve treatment outcomes associated with Massed PE and (2) Do differences in psychophysiological arousal during the exposure portion of treatment help explain treatment outcomes for PTSD. Participants will receive ten 90-minute session of Massed PE. Between the first and second Massed PE sessions, half of the participants will receive a SGB, and half will receive a sham SGB.

Read the detailed description

Massed PE will be conducted by master-level or doctoral-level therapists. Participants will meet with their providers for individual, 90-minute sessions. They will then be asked to complete out-of-session treatment assignments throughout the rest of the day. Between the individual therapy session and out-of-session treatment assignments, participants will engage in approximately four to six hours of treatment per day, Monday through Friday, for two weeks. Each participant will also be offered three booster sessions at 1-, 3-, and 7-weeks posttreatment.

The stellate ganglion block injection or the sham SGB will be administered between the first and second massed PE session by qualified medical personnel as per standard operating procedure for the placement of a stellate ganglion block. A research nurse will be in attendance during the procedure and for an hour recovery period following the block administration.

Assessments will be administered at pretreatment, during treatment, at posttreatment, and at 1-, 3-, and 6-months following the completion of PE. The primary outcome assessment will be 1-month following the completion of PE. Following this assessment, participants randomized to the sham SGB arm of the study will be offered an SGB with ropivacaine.

Being tested
Ropivacaine injection, Normal saline
Keywords
SGB, Military
Medical subject headings
Stress Disorders, Post-Traumatic

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Ropivacaine injectionDrug

    Also called Naropin

    6.5cc of Ropivacaine hydrochloride (HCl) 0.5%, one time into the stellate ganglion

  • Normal salineDrug

    6.5cc of Normal Saline one time into the stellate ganglion.

Study groups in NCT05889741
Study groupRoleWhat they receive
Stellate Ganglion BlockExperimentalOne time administration of a stellate ganglion block
Receives: Drug: Ropivacaine injection
Sham SGBPlacebo comparatorOne time administration
Receives: Drug: Normal saline

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change from baseline in Clinician-Administered PTSD Scale-DSM 5 (CAPS-5)

    A 30-item structured interview used to assess change symptoms of PTSD. Questions target the onset and duration of symptoms, subjective distress, impact on social and occupational functioning. Total severity scores range from 0 to 80 with higher score indicative of greater PTSD severity. The measure can also be used to confirm the presence of a PTSD diagnosis.

    Measured: Baseline and at 1-month, 3-month, and 6-month follow-up assessments

  2. Change from baseline in Posttraumatic Stress Disorder Checklist -DSM 5 (PCL-5)

    A 20-item self-report measure that assesses the presence and change in severity of PTSD symptoms using the Diagnostic and Statistical Manual of mental disorders (DSM-5). Total severity scores range from 0 to 80 with higher score indictive of greater PTSD severity.

    Measured: Baseline and at 1-month, 3-month, and 6-month follow-up assessments

Secondary outcomes (10)
  1. Patient Health Questionnaire-9 items (PHQ-9)

    A 9-item self-report measure that assesses the presence and change in severity of depressive symptoms. Total scores range from 0 to 27 with higher scores reflective of greater severity.

    Measured: Baseline and at 1-month, 3-month, and 6-month follow-up assessments

  2. General Anxiety Disorder Screener - 7 Items (GAD-7)

    A 9-item self-report measure that assesses the presence and change in severity of general anxiety symptoms. Total scores range from 0 to 21 with higher scores reflective of greater severity.

    Measured: Baseline and at 1-month, 3-month, and 6-month follow-up assessments

  3. Posttraumatic Cognitions Inventory (PTCI)

    A 36-item self-report measure that assesses change in self-blame, negative cognitions about self, and negative cognitions about the world following trauma exposure. Total scores range from 33 to 231 with higher scores reflective of more problematic cognitions.

    Measured: Baseline and at 1-month, 3-month, and 6-month follow-up assessments

  4. Psychophysiological arousal - Galvanic Skin Response

    Change in Psychophysiological data collected from a smart watch measuring galvanic skin response

    Measured: Two weeks

  5. Psychophysiological arousal - Skin Temperature

    Change in Psychophysiological data collected from a smart watch measuring skin temperature

    Measured: Two weeks

  6. Psychophysiological arousal - Heart Rate

    Change in Psychophysiological data collected from a smart watch measuring heart rate

    Measured: Two weeks

  7. Psychophysiological arousal - Interbeat Interval

    Change in Psychophysiological data collected from a smart watch measuring interbeat interval

    Measured: Two weeks

  8. Psychophysiological arousal - Three-Dimensional Accelerometer Movement

    Change in Psychophysiological data collected from a smart watch measuring three-dimensional accelerometer movement

    Measured: Two weeks

  9. Psychophysiological arousal - Electrodermal Activity

    Change in Psychophysiological data collected from a smart watch measuring electrodermal activity

    Measured: Two weeks

  10. Psychophysiological arousal - Photoplethysmography

    Change in Psychophysiological data collected from a smart watch measuring photoplethysmography

    Measured: Two weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted5 Jun 2023
  2. Study start26 Feb 2024
  3. Primary completion31 Mar 2027 (estimated)
  4. Study completion31 Aug 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Triple blind
Who is masked
Participant, Investigator, Outcomes assessor
Enrolment
140 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05889741
Sponsor's protocol ID
HSC20230087H
Status last verified
Aug 2025
First submitted
17 Apr 2023
Last updated
4 Sep 2025
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Publications

  • Foa EB, McLean CP, Zang Y, Rosenfield D, Yadin E, Yarvis JS, Mintz J, Young-McCaughan S, Borah EV, Dondanville KA, Fina BA, Hall-Clark BN, Lichner T, Litz BT, Roache J, Wright EC, Peterson AL; STRONG STAR Consortium. Effect of Prolonged Exposure Therapy Delivered Over 2 Weeks vs 8 Weeks vs Present-Centered Therapy on PTSD Symptom Severity in Military Personnel: A Randomized Clinical Trial. JAMA. 2018 Jan 23;319(4):354-364. doi: 10.1001/jama.2017.21242.

    PubMed 29362795
  • Hanling SR, Hickey A, Lesnik I, Hackworth RJ, Stedje-Larsen E, Drastal CA, McLay RN. Stellate Ganglion Block for the Treatment of Posttraumatic Stress Disorder: A Randomized, Double-Blind, Controlled Trial. Reg Anesth Pain Med. 2016 Jul-Aug;41(4):494-500. doi: 10.1097/AAP.0000000000000402.

    PubMed 27187898
  • Lipov EG, Joshi JR, Lipov S, Sanders SE, Siroko MK. Cervical sympathetic blockade in a patient with post-traumatic stress disorder: a case report. Ann Clin Psychiatry. 2008 Oct-Dec;20(4):227-8. doi: 10.1080/10401230802435518. No abstract available.

    PubMed 19034755
  • Lynch JH, Mulvaney SW, Kim EH, de Leeuw JB, Schroeder MJ, Kane SF. Effect of Stellate Ganglion Block on Specific Symptom Clusters for Treatment of Post-Traumatic Stress Disorder. Mil Med. 2016 Sep;181(9):1135-41. doi: 10.7205/MILMED-D-15-00518.

    PubMed 27612365
  • Mulvaney SW, Lynch JH, Hickey MJ, Rahman-Rawlins T, Schroeder M, Kane S, Lipov E. Stellate ganglion block used to treat symptoms associated with combat-related post-traumatic stress disorder: a case series of 166 patients. Mil Med. 2014 Oct;179(10):1133-40. doi: 10.7205/MILMED-D-14-00151.

    PubMed 25269132
  • Odosso RJ, Petta L. The Efficacy of the Stellate Ganglion Block as a Treatment Modality for Posttraumatic Stress Disorder Among Active Duty Combat Veterans: A Pilot Program Evaluation. Mil Med. 2021 Jul 1;186(7-8):e796-e803. doi: 10.1093/milmed/usaa246.

    PubMed 33242072
  • Peterson AL, Blount TH, Foa EB, Brown LA, McLean CP, Mintz J, Schobitz RP, DeBeer BR, Mignogna J, Fina BA, Evans WR, Synett S, Hall-Clark BN, Rentz TO, Schrader C, Yarvis JS, Dondanville KA, Hansen H, Jacoby VM, Lara-Ruiz J, Straud CL, Hale WJ, Shah D, Koch LM, Gerwell KM, Young-McCaughan S, Litz BT, Meyer EC, Blankenship AE, Williamson DE, Roache JD, Javors MA, Sharrieff AM, Niles BL, Keane TM; Consortium to Alleviate PTSD. Massed vs Intensive Outpatient Prolonged Exposure for Combat-Related Posttraumatic Stress Disorder: A Randomized Clinical Trial. JAMA Netw Open. 2023 Jan 3;6(1):e2249422. doi: 10.1001/jamanetworkopen.2022.49422.

    PubMed 36602803

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Ropivacaine injection and Normal saline in people with Stress Disorders, Post-Traumatic, run by The University of Texas Health Science Center at San Antonio at 2 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 16 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 4 Sep 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Amanda Flores (210-562-6726, floresa13@uthscsa.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change from baseline in Clinician-Administered PTSD Scale-DSM 5 (CAPS-5) (time frame: Baseline and at 1-month, 3-month, and 6-month follow-up assessments). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05889741, which also lists 7 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 4 Sep 2025.

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