Stellate ganglion block for ischemic optic neuropathy : a comparison with steroids / 中华麻醉学杂志

ABSTRACT

Objective To evaluate the efficacy of stellate ganglion block ( SGB) in the treatment of ischemic optic neuropathy ( ION ) as compared with that of steroids. Methods Eighty-two eyes were involved in seventy patients with ION. The patients were randomly assigned to receive either steroids (dexamethason 15 mg iv q.d. for 5-10 days followed by peroral prednisone 20 mg q.d.) ( n = 34, 38 eyes) or ipsilateral SGB (2% lidocaine 2-3 ml q.d. 10-15 days) ( n = 36, 44 eyes). The criteria for judging the efficacy of the treatment were changes in visual acuity, ocular fundus, visual field and visual evoked potential (VEP) . The effectiveness of the treatment was divided into four grades excellent, good, improved and no effect. Results In steroid group the results of treatment were rated as excellent for 10, good for 12, improved for 3 and no effect for 13 eyes (the overall success rate was 65.8%), while in SGB group the results were rated as excellent for 15, good for 14, improved for 5 and no effect for 10 eyes ( the overall success rate was 77.3 % ). In patients who were successfully treated, the visual acuity improved, the pale edema of optic papilla was disappearing and the color and blood vessels of retina were returning to normal. The latent time of VEP P100 was significantly shortened and the amplitude increased in both groups. Conclusion SGB is a safe, reliable and effective method of treatment for ION.