Discussion
Sleep disturbance, chronic pain, hyperhidrosis, pain
CHRONIC PAIN, ADVERSE REACTION, SYNDROME, HORNER SYNDROME
SGB is widely used in the treatment of chronic pain and complex regional localized pain syndrome (The clinical data related to the effect of SGB on hot flash treatment are limited, and most are case reports, so the level of evidence is not high (SGB is considered a relatively safe clinical procedure, with a serious adverse reaction rate of 1.7/1000 as reported by Wulf and Maier (The mechanism of SGB in preventing and treating hot flashes has not yet been elucidated as it is a block of sympathetic nerve conduction. Lipov believes that the therapeutic effect is based on interrupting the connection between the central nervous system and the sympathetic nervous system (SGB was initially used in the treatment of hyperhidrosis, which has similarities to hot flashes in terms of symptom presentation (Sleep disturbance is another major concern for perimenopausal women and is often accompanied by hot flashes (This study has certain limitations. First, the patients who underwent SGB treatment exhibited significant Horner syndrome, which prevented double-blinding between the investigator and the study subjects and caused possible subjective information bias of the investigator. Second, the sample size of this study was relatively small, not a multicentre, large-sample clinical study with good representation, and PP analysis may have caused overestimation of the treatment effect and reduced the reliability of the experimental results. Third, the goal of this trial is to seek a long-term effective method to alleviate hot flashes in perimenopausal or even postmenopausal women, and the follow-up period of this trial is far from adequate due to research funding constraints and other reasons. Fourth, the time interval between the subjects’ visits to the hospital and the evaluation was too long, and our trial indicators, including hot flash score, hot flash frequency, Kupperman scale, and Pittsburgh sleep scale, originated from subjects’ subjective evaluation. Fifth, in our trial, we only compared the efficacy of SGB with that of saline and did not compare the difference between hormone replacement therapy, paroxetine, or any other pharmacological treatments. A comparison of the safety and efficacy of several therapies would have revealed the best recommendation for hot flash relief.