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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Gomaa Zohry Hussien
Fatma Ibrahim Salman
Sandra Mohamed Ahmed
Haytham Rizk
Ahmed Ragab Abdel Hakeim


Superior cervical ganglion, middle cerebral artery aneurysm and transcranial Doppler


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.

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