To investigate whether stellate ganglion block is helpful to brain protection during cranial aneurysm surgery
The vasospasm after cranial aneurysm surgery have a higher incidence, but not have an ideal treatment method. At present, the medical treatment is very limited effect to prevent the perioperative cerebral ischemia.Stellate ganglion block （SGB）is an effective and well-tolerated approach to the treatment of CVS in various clinical settings.Resent study indicated that SGB has a protective effect on delayed cerebral vasospasm in an experimental rat model of subarachnoid hemorrhage.Therefore,we hypothesized that the preoperative SGB would be a effective treatment for improvement of vasospasm after cranial aneurysm surgery.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
SINGLE
Enrollment
40
stellate ganglion block will be administered using either 6-8mL saline (Group 1) or 0.25% ropivacaine 6-8mL (Group 2)
General Hospital of Ningxia Medical University
Yinchuan, Ningxia, China
The incidence of cerebral vasospasm
The occurrence of cerebral vasospasm will be diagnosed by using of the transcranial doppler instrument.
Time frame: Change from baseline at 2hour,6hour,1day,3day,and 7day after aneurysm surgery
Perioperative cerebral oxygen metabolism
Cerebral oxygen metabolism will be monitored through jugular venous oxygen saturation (SjVO2) and cerebral extraction rate of oxygen (CERO2), and measured by blood gas analysis at each time point, the latter will be calculated using the formula: CaO2 = (Hb\*1.38\*SaO2) + (0.003\*PaO2); CvO2 = (Hb\*1.38\*SjvO2) + (0.003\*PjvO2); CERO2 = (CaO2-CvO2)/CaO2 where CaO2 is arterial oxygen content, Hb is arterial hemoglobin concentration, SaO2 is arterial oxygen saturation, PaO2 is the arterial partial pressure of oxygen, CvO2 is mixed venous oxygen content and PjvO2 is the jugular venous partial pressure of oxygen.
Time frame: Change from baseline at 2hour,6hour,1day,3day,and 7day postoperatively
The difference of plasma endothelin, melatonin, and S100-β protein level between two groups at each time point
A 5-mL jugular venous blood sample will be taken at each time point, centrifuged at 3,000 rpm for 25 min, and kept in a freezer at -80°C until analysis. the concentrations of plasma endothelin, melatonin, and S100-β protein will be measured using enzyme-linked immunosorbent assays.
Time frame: Change from baseline at 2hour,6hour,1day,3day,and 7day postoperatively
Postoperative cognitive function
The postoperative cognitive function will be measured by using of the mini-mental state examination (MMSE).
Time frame: Change from baseline at 2hour,6hour,1day,3day,and 7day after aneurysm surgery
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