Abstract:ObjectiveThis study aims to observe the preventive effect and safety of stellate ganglion block(SGB) on paroxysmal sympathetic hyperactivity(PSH) in patients with traumatic brain injuries(TBI). MethodsA retrospective cohort study was carried out in patients with TBI admitted to High Dependency Unit(HDU) from 1st September 2023 to 28th September 2024 at Shanghai Yangzhi Rehabilitation Hospital. The eligible patients were divided into an SGB group and a control group depending on whether they received ultrasound-guided SGB during hospital stay. The primary outcome measured was the incidence of PSH during hospitalization, defined by a PSH-AM score≥8 points. The secondary outcomes included Glasgow coma score(GCS) score at discharge, blood pressure and heart rate before and after SGB, and the occurrence of adverse events including but not limited to nerve injury, neck hematoma, or hoarseness, etc. Multivariate regression models were employed to adjust for confounding factors, and subgroup analyses were performed to confirm the robustness of the findings. ResultsThe study included a total of 234 patients, 101 of whom had sustained TBI, 48 of them underwent ultrasound-guided SGB treatment. The multivariate regression analysis revealed that patients undergoing SGB experienced a significantly lower incidence of PSH than those who did not receive SGB treatment during hospitalization(P<0.05). Additionally, systolic blood pressure and heart rate significantly decreased following SGB treatment, while diastolic blood pressure remained unchanged. No adverse events, including nerve injury, neck hematoma, or hoarseness, were reported during the treatment. ConclusionIt indicated that ultrasound-guided SGB significantly reduces the incidence of PSH after TBI, has the preventive effect and improves the patients neurological function score . These findings underscore the potential therapeutic benefits of SGB; however, additional prospective randomized controlled trials are needed to confirm its efficacy.
