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Effects of stellate ganglion block on early brain injury in patients with subarachnoid hemorrhage: a randomised control trial

BACKGROUND: Subarachnoid hemorrhage (SAH) is a common neurosurgical emergency, and early brain injury (EBI) plays an important role in acute brain injury of SAH. Our objective is to investigate the effect of stellate ganglion block (SGB) on the clinical prognosis of patients with SAH (registration n...

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Autores principales: Zhang, Jian, Nie, Ying, Pang, Qiongni, Zhang, Xubiao, Wang, Qianting, Tang, Jing
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7816408/
https://www.ncbi.nlm.nih.gov/pubmed/33472582
http://dx.doi.org/10.1186/s12871-020-01215-3
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author Zhang, Jian
Nie, Ying
Pang, Qiongni
Zhang, Xubiao
Wang, Qianting
Tang, Jing
author_facet Zhang, Jian
Nie, Ying
Pang, Qiongni
Zhang, Xubiao
Wang, Qianting
Tang, Jing
author_sort Zhang, Jian
collection PubMed
description BACKGROUND: Subarachnoid hemorrhage (SAH) is a common neurosurgical emergency, and early brain injury (EBI) plays an important role in acute brain injury of SAH. Our objective is to investigate the effect of stellate ganglion block (SGB) on the clinical prognosis of patients with SAH (registration number ChiCTR2000030910). METHODS: A randomized controlled trial was conducted with 102 participants. Patients with SAH were assigned to the SGB or nSGB group. Patients in the SGB group received SGB four times (once every other day starting on the day of the surgery). In contrast, patients in the nSGB group only received standard care. Data were collected on the day before surgery (T0) and on the 1(st) (T1), 3(rd) (T2) and 7(th) day (T3) after surgery. The primary outcomes included EBI markers (including IL-1β, IL-6, TNF-α, ET-1, NPY, NSE and S100β), the mean cerebral blood flow velocity of the middle cerebral artery (Vm-MCA) and the basilar artery (Vm-BA). All cases were followed up for 6 months after surgery. RESULTS: The levels of the EBI markers in both groups were higher at T1–T3 than at T0 (P<0.05), and the Vm-MCA and Vm-BA were also increased at the same times. However, the levels of the EBI markers were lower in the SGB group than in the nSGB group (P<0.05), and the increases of Vm-MCA and Vm-BA were also lower (P<0.05). The prognosis score and neurological deficit were better in the SGB group than in the nSGB group (P<0.05). CONCLUSIONS: SGB can improve the prognosis of SAH patients by inhibiting the inflammatory response during EBI and by reducing endothelial dysfunction and relieving CVS. TRIAL REGISTRATION: Clinical trial number: ChiCTR2000030910; Registry URL: Chinese Clinical Trial Registry; Principal investigator's name: Ying Nie; Date of Trial registration: March, 2020 (retrospectively registered). SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12871-020-01215-3.
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spelling pubmed-78164082021-01-21 Effects of stellate ganglion block on early brain injury in patients with subarachnoid hemorrhage: a randomised control trial Zhang, Jian Nie, Ying Pang, Qiongni Zhang, Xubiao Wang, Qianting Tang, Jing BMC Anesthesiol Research Article BACKGROUND: Subarachnoid hemorrhage (SAH) is a common neurosurgical emergency, and early brain injury (EBI) plays an important role in acute brain injury of SAH. Our objective is to investigate the effect of stellate ganglion block (SGB) on the clinical prognosis of patients with SAH (registration number ChiCTR2000030910). METHODS: A randomized controlled trial was conducted with 102 participants. Patients with SAH were assigned to the SGB or nSGB group. Patients in the SGB group received SGB four times (once every other day starting on the day of the surgery). In contrast, patients in the nSGB group only received standard care. Data were collected on the day before surgery (T0) and on the 1(st) (T1), 3(rd) (T2) and 7(th) day (T3) after surgery. The primary outcomes included EBI markers (including IL-1β, IL-6, TNF-α, ET-1, NPY, NSE and S100β), the mean cerebral blood flow velocity of the middle cerebral artery (Vm-MCA) and the basilar artery (Vm-BA). All cases were followed up for 6 months after surgery. RESULTS: The levels of the EBI markers in both groups were higher at T1–T3 than at T0 (P<0.05), and the Vm-MCA and Vm-BA were also increased at the same times. However, the levels of the EBI markers were lower in the SGB group than in the nSGB group (P<0.05), and the increases of Vm-MCA and Vm-BA were also lower (P<0.05). The prognosis score and neurological deficit were better in the SGB group than in the nSGB group (P<0.05). CONCLUSIONS: SGB can improve the prognosis of SAH patients by inhibiting the inflammatory response during EBI and by reducing endothelial dysfunction and relieving CVS. TRIAL REGISTRATION: Clinical trial number: ChiCTR2000030910; Registry URL: Chinese Clinical Trial Registry; Principal investigator's name: Ying Nie; Date of Trial registration: March, 2020 (retrospectively registered). SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12871-020-01215-3. BioMed Central 2021-01-20 /pmc/articles/PMC7816408/ /pubmed/33472582 http://dx.doi.org/10.1186/s12871-020-01215-3 Text en © The Author(s) 2021 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Zhang, Jian
Nie, Ying
Pang, Qiongni
Zhang, Xubiao
Wang, Qianting
Tang, Jing
Effects of stellate ganglion block on early brain injury in patients with subarachnoid hemorrhage: a randomised control trial
title Effects of stellate ganglion block on early brain injury in patients with subarachnoid hemorrhage: a randomised control trial
title_full Effects of stellate ganglion block on early brain injury in patients with subarachnoid hemorrhage: a randomised control trial
title_fullStr Effects of stellate ganglion block on early brain injury in patients with subarachnoid hemorrhage: a randomised control trial
title_full_unstemmed Effects of stellate ganglion block on early brain injury in patients with subarachnoid hemorrhage: a randomised control trial
title_short Effects of stellate ganglion block on early brain injury in patients with subarachnoid hemorrhage: a randomised control trial
title_sort effects of stellate ganglion block on early brain injury in patients with subarachnoid hemorrhage: a randomised control trial
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7816408/
https://www.ncbi.nlm.nih.gov/pubmed/33472582
http://dx.doi.org/10.1186/s12871-020-01215-3
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