Efficacy of superior cervical ganglion (SCG) block on the incidence and severity of vasospasm after middle cerebral artery (MCA) aneurysmal surgery using transcranial Doppler (TCD): A Randomized controlled trial
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Keywords
Superior cervical ganglion, middle cerebral artery aneurysm and transcranial Doppler
Abstract
Background: In this study we assess blood flow velocity in middle cerebral artery measured by transcranial Doppler (TCD) to determine the efficacy of superior cervical ganglion (SCG) block in decreasing incidence or severity of vasospasm after middle cerebral artery (MCA) aneurysmal surgery.
Methods: A total number of 36 patients were included in this study. The study was designed to recruit ASA I-II patients who have ruptured aneurysm and subarachnoid hemorrhage (SAH), aged from 18 to 70 years undergoing MCA aneurysmal surgeries. They were randomly divided by computer designed lists then concealed in closed envelopes into two equal groups (18/group): Group (A): control study & Group (B): superior cervical block. Results: The findings demonstrated that the mean flow velocity (MFV) after SCGB was reduced in day 3 and day 7 postoperative which was detected by TCD from MFV in day 0 preoperative, and also there was decrease in Lindegaard ratio after SCGB in concomitant with decrease in MFV.
Conclusion: Superior cervical ganglion block may be effective in reducing MFV in middle cerebral artery which is detected by transcranial doppler, so it may lead to improve mild and moderate vasospasm after subarachnoid haemorrhage with haemodynamic stability after injection and without complications occurred.
References
2. Elsner F, Radbruch L, Gaertner J, Straub U. & Sabatowski R. Efficacy of opioid analgesia at the superior cervical ganglion in neuropathic head and facial pain. Schmerz (Berlin, Germany). 2006; 20(4): 268-72, 274-6.
3. Koning H.M, Dyrbye B.A. & van Hemert F.J. Percutaneous radiofrequency lesion of the superior cervical sympathetic ganglion in patients with tinnitus. Pain Practice.2016;16(8): 994-1000.
4. Treggiari MM, Romand JA, Martin JB. et al. Cervical sympathetic block to reverse delayed ischemic neurological deficits after aneurysmal subarachnoid hemorrhage. Stroke 2003; 34:961–7.
5. Aaslid R, Markwalder T-M, Nornes H. Non-invasive transcranial Doppler ultrasound recording of flow velocity in basal cerebral arteries. J Neurosurg. 1982 Dec; 57(6):769–74.
6. Gisvold SE, Brubakk AO.Measurement of instantaneous blood-flow velocity in the human aorta using pulsed Doppler ultrasound.Cardiovasc Res. 1982 Jan; 16(1):26–33.
7. Aaslid R, Brubakk AO.Accuracy of an ultrasound Doppler servo method for noninvasive determination of instantaneous and mean arterial blood pressure.Circulation.1981; 64(4).
8. Li D.D, Chang J.Y, Zhou C.X. & Cui J.B. Clinical diagnosis of cerebral vasospasm after subarachnoid hemorrhage by using transcranial Doppler sonography. European review for medical and pharmacological sciences.2018, 22; 2029-35.
9. Nassar H.G.E, Ghali A.A, Bahnasy W.S. & Elawady M.M. Vasospasm following aneurysmal subarachnoid hemorrhage: prediction, detection, and intervention. The Egyptian journal of neurology, psychiatry and neurosurgery. 2019; 55(1), 1-6.
10. Jain V, Rath GP, Dash HH, Bithal PK, Chouhan RS, Suri A. Stellate ganglion block for treatment of cerebral vasospasm in patients with aneurysmal subarachnoid hemorrhage - A preliminary study. J Anaesthesiol Clin Pharmacol. 2011; 27(4):516-21.
11. YANG, Xuefen, WANG, Gui, XU, Chunhong. Application of ultrasound-guided stellate ganglion block in patients with aneurysmal intracerebral hemorrhage. Chinese Journal of Postgraduates of Medicine. 2020; 235-8.
12. Zhang J, Nie Y, Pang Q, Zhang X, Wang Q. & Tang J. Effects of stellate ganglion block on early brain injury in patients with subarachnoid hemorrhage: a randomised control trial. BMC anesthesiology. 2021; 21(1), 1-11.
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