Effectiveness of Stellate Ganglion Block on Chest Pain Severity and St-Segment Changes in Patients With Refractory Angina: An Interventional Study Publisher



Espahbodi E ; Raji M ; Rahmani R ; Samimi S ; Rahmanian M ; Karbasforoshan A ; Sanatkar M
Source: Archives of Anesthesiology and Critical Care Published:2026

Abstract

Background: Refractory angina remains a major therapeutic challenge when revascularization options are unavailable. Stellate ganglion block (SGB) may reduce sympathetic tone, improve coronary perfusion, and alleviate ischemic chest pain. This study evaluated the effects of SGB on the severity of chest pain and ST-segment deviation during exercise testing. Methods: This before–and–after interventional study included patients with confirmed coronary artery disease and refractory angina. Baseline treadmill testing assessed angina index and ST-segment deviation. SGB was performed under ultrasound guidance using 0.25% bupivacaine and dexamethasone. Treadmill testing was repeated 24–48 hours after the block. Results: Sixteen patients participated (56% male; mean age 60.7±9.7 years). The angina index significantly improved (1.90±0.34 to 0.50±0.32; P < 0.001). ST-segment deviation decreased modestly but significantly (1.0±0.4 to 0.9±0.3 mm; P=0.041). No major complications occurred. Conclusion: SGB significantly reduced chest pain severity and improved ischemic ST-segment abnormalities in patients with refractory angina. It may serve as a safe and effective adjunct therapy. Copyright © 2026 Tehran University of Medical Sciences.