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CASE REPORT
Year : 2020  |  Volume : 36  |  Issue : 2  |  Page : 265-267

Continuous stellate ganglion block in delayed cerebral ischemia: A possible supplementary approach to traditional therapy?


1 Institute of Anesthesia and Intensive Care Medicine, University Hospital of Padova, Padova, Italy
2 Institute of Radiology, University Hospital of Padova, Padova, Italy
3 Neuroanesthesia and Intensive Care Unit, University Hospital of Padova, Padova, Italy

Correspondence Address:
Dr. Andrea Bortolato
Anesthesia and Intensive Care University-Hospital of Padua, Via Nicolò Giustiniani n. 2, 35121 Padova
Italy
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/joacp.JOACP_251_19

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Delayed Cerebral Ischemia (DCI) is a major contributor to morbidity and mortality after SAH. Currently the prevention of vasospasm and DCI relies on nimodipine administration and on maintaining an adequate cerebral perfusion pressure. We report a patient with initial DCI after SAH in which stellate ganglion block (SGB) was performed after nimodipine administration. Firstly the procedure was characterized by a iv and intra-arterial nimodipine administration which did not result into a normal perfusion pattern. Therefore a single-shot stellate ganglion block was performed, as suggested in literature. Because of the not sufficient but promising perfusion improvement, we decided to deliver a continuous ganglion block (cSGB) for 5 days. Consequently a further improvement of the cerebral perfusion on CTPerfusion and Real Time Angiographic Perfusion Assessment was registered. In order to treat cerebral vasospasm, SGB is known to be a further valuable treatment, despite its temporary effect. However the continuous use of SGB during initial DCI has never been described before.


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