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"Emergency medicine" 4 (75) 2016

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Changes in Cerebral Blood Flow after Stellate Ganglion Block

Authors: Yevstratov Eugene, Krupskaya Natalia, Dashyan Narine
Pain Clinic of St. Katherine Hospital Cardiology, Odessa, Ukraine

Sections: Medical forums

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Background and Goal of Study. Stellate ganglion block (SGB) has been used in the treatment of cerebral derangements thought to be associated with a headache, for the purpose of reliving spasm and presumably increasing the cerebral blood flow, normalizing endovascular resistances, number of clinical observations, ascribing dramatic results of stellate block to the release of cerebral angiospasm.
Materials and Methods. Unilateral SGB was performed on 30 volunteers patients, 30–40 years (21 female, 9 male), with cluster headache, with 5 ml 0.250 ropivacaine + 4 mg dexamethasone using a paratracheal ultrasound guided technique at the C6 level and confirmed by the presence of Horner’s syndrome. The resistive index (RI) was measured by ultrosound transcranial CV doppler of middle cerebral artery at baseline and 1 min, and 10 min after SGB on both sides (the other side was taken as a control). Normal values of RI was taken according the age.
Results and Discussion. Our observation that, unila–teral, compromised side, after SGB, in our patient produce measurable change in the RI, in contrast with the presumption that this procedure leads to dilatation of the cerebral vessels and normalize RI at middle cerebral artery.
Conclusions. The difference between the block and the non-block sides was significant before procedure (p < 0,0001) and after 10 min become the same with an insignificant difference (p = 0,001). Possible will be as an indicator for decision of the block side (with a higher RI in patients with a cluster headache. Ultrasound technique will be helpfull for provide safe block and effect control.

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