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Stellate Ganglion Block in Subarachnoid Hemorrhage: A Promising Protective Measure against Vasospasm?

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dc.contributor.author de Barros Oliveira, Leonardo
dc.contributor.author Batista, Sávio
dc.contributor.author Prestes, Milena Zadra
dc.contributor.author Bocanegra Becerra, Jhon Ernesto
dc.contributor.author Rabelo, Nicollas Nunes
dc.contributor.author Bertani, Raphael
dc.contributor.author Welling, Leonardo Christiaan
dc.contributor.author Figueiredo, Eberval Gadelha
dc.date.accessioned 2023-12-07T22:33:25Z
dc.date.available 2023-12-07T22:33:25Z
dc.date.issued 2023
dc.identifier.uri https://hdl.handle.net/20.500.12866/14724
dc.description.abstract BACKGROUND: Stellate ganglion block (SGB) may have protective effects in patients at risk of vasospasm following subarachnoid hemorrhage (SAH) due to reduced sympathetic activity. However, the safety and clinical outcomes of SGB in this scenario are not definitively known. The objective was to evaluate the safety, clinical outcomes, and cerebral blood flow velocity in patients submitted to SGB or cervical sympathectomy with SAH. METHODS: Following PRISMA guidelines, a systematic review and meta-analysis of studies investigating SGB or cervical sympathectomy use in SAH were conducted. PubMed, Cochrane Library, and Embase were evaluated. Patients with mRS from 0 to 2, GOS from 4 to 5, or symptom resolution were considered favorable clinical outcomes. Related mortality was defined as death by vasospasm or delayed cerebral ischemia. RESULTS: The analysis included eight studies comprising 182 patients. Only two studies employed SGB prophylactically. The results revealed favorable outcomes in 52% of patients (95% CI: 37% - 65%). The overall incidence of complications was 2% (95% CI: 0% - 26%). The mortality rate was 13% (95% CI: 7% - 21%), with a vasospasm-related mortality rate of 11% (95% CI: 2% - 20%). A decrease of cerebral blood flow velocity was reported in four studies. CONCLUSION: The notable reduction in CBFV following SGB, alongside positive outcomes and a low occurrence of mortality and complications, highlights its significance as a therapeutic intervention for vasospasm following SAH. While the number of studies evaluating SGB as a preventive measure is limited, the promising results emphasize the importance of future research. en_US
dc.language.iso eng
dc.publisher Elsevier
dc.relation.ispartofseries World Neurosurgery
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject SAH en_US
dc.subject SGB en_US
dc.subject Stellate Ganglion Block en_US
dc.subject Subarachnoid Hemorrhage en_US
dc.subject Vasospasm en_US
dc.subject.mesh Hemorragia Subaracnoidea
dc.subject.mesh Vasoespasmo Coronario
dc.title Stellate Ganglion Block in Subarachnoid Hemorrhage: A Promising Protective Measure against Vasospasm? en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1016/j.wneu.2023.11.122
dc.relation.issn 1878-8769

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