Combining Stellate Ganglion Block With Prolonged Exposure for PTSD

Inclusion Criteria: 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. Exclusion Criteria: 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 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