Document Detail

Stellate ganglion block for treatment of cerebral vasospasm in patients with aneurysmal subarachnoid hemorrhage - A preliminary study.
MedLine Citation:
PMID:  22096287     Owner:  NLM     Status:  PubMed-not-MEDLINE    
BACKGROUND: Stellate ganglion block improves cerebral perfusion by decreasing the cerebral vascular tone. Its effects on cerebral vasospasm to relieve neurological deficits have not been evaluated. This prospective observational study was carried out to evaluate the effect of stellate ganglion block on cerebral hemodynamics in patients with symptomatic cerebral vasospasm following aneurysmal subarachnoid hemorrhage.
MATERIALS AND METHODS: Fifteen patients of either sex, aged 18-75 years, who underwent surgical clipping of aneurysm and developed refractory cerebral vasospasm were included. Stellate ganglion block was performed using 10 ml of bupivacaine 0.5% on the side with maximum cerebral blood flow velocity. Neurological status, cerebral blood flow velocity and pulsatility index were assessed before and 10 minutes, 30 minutes, 2 hours, 6 hours, 12 hours and 24 hours after stellate ganglion block.
RESULTS: Improved Glasgow coma score was observed 30 minutes after stellate ganglion block. Neurological deficits reduced in 11 patients. Ipsilateral middle cerebral artery mean flow velocity decreased from 133.66 cm/sec before stellate ganglion block to 110.53 cm/sec at 6 hours (P<0.001) and 121.62 cm/sec at 24 hours (P<0.001) after stellate ganglion block. There was a decrease in ipsilateral anterior cerebral artery mean flow velocity after stellate ganglion block (P<0.001), which persisted for 12 hours. A decline in flow velocities was observed in contralateral middle cerebral artery (P=0.008) and anterior cerebral artery (P=0.041) for 12 hours.
CONCLUSION: This study suggests stellate ganglion block to be an effective modality of treatment for refractory cerebral vasospasm after aneurysmal subarachnoid hemorrhage.
Virendra Jain; Girija P Rath; Hari H Dash; Parmod K Bithal; Rajendra S Chouhan; Ashish Suri
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of anaesthesiology, clinical pharmacology     Volume:  27     ISSN:  2231-2730     ISO Abbreviation:  J Anaesthesiol Clin Pharmacol     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-11-18     Completed Date:  2011-11-23     Revised Date:  2014-01-24    
Medline Journal Info:
Nlm Unique ID:  9516972     Medline TA:  J Anaesthesiol Clin Pharmacol     Country:  India    
Other Details:
Languages:  eng     Pagination:  516-21     Citation Subset:  -    
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