Infiltration of the sphenopalatine ganglion decreases blood pressure in newly diagnosed and never treated patients with essential hypertension

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• 作者：Helen Triantafyllidi^a ; ^{seliani@hotmail.com" class="auth_mail" title="E-mail the corresponding author} ; Chrysa Arvaniti^b ; Leonidas Palaiodimos^a ; Stefanos Vlachos^a ; Antonios Schoinas^a ; Chrysanthi Batistaki^b ; Georgia Kostopanagiotou^b ; John Lekakis^a
• 关键词：Sphenopalatine ganglion ; Neural block ; Arterial hypertension ; 24  ; h blood pressure measurement (24  ; h ABPM)
• 刊名：International Journal of Cardiology
• 出版年：2016
• 出版时间：15 November 2016
• 年：2016
• 卷：223
• 期：Complete
• 页码：345-351
• 全文大小：531 K

文摘

Sphenopalatine ganglion (SPG), an extracranial structure, is connected with the central nervous system (CNS) through sympathetic and parasympathetic nerves. We hypothesized that SPG block through sympathetic nerves anesthesia might decrease blood pressure (BP) in recently diagnosed and never treated middle-aged patients with essential hypertension.

Methods

We performed SBG block in 22 hypertensive patients (mean age 45 ± 12 years, 15 men). All patients have been subjected to 24 hour ambulatory blood pressure monitoring a week prior the procedure as well as in a period of 21–30 days after the SBG block in order to estimate differences in 24 h average systolic (24 h SBP) and diastolic blood pressure (24 h DBP), daytime, nighttime, pre-awake and early morning SBP and DBP as well as BP load.

Results

We found that 24 h SBP (p = 0.001) and 24 h DBP (p < 0.001), daytime SBP and DBP (p < 0.001) as well as daytime SBP and DBP load (p = 0.002 and p < 0.001, respectively) were decreased in total population at 21–30 days after SPG block. In 11/22 responders (24 h SBP decrease ≥ 5 mm Hg), SBP and DBP were reduced during overall 24 h and daytime (p < 0.001) and nighttime periods (p = 0.01 and p = 0.06, respectively) while pre-awake SBP (p = 0.09) along with daytime SBP and DBP load (p = 0.07 and p = 0.06, respectively) were also almost decreased.

Conclusions

SBG block might be a promising, non-invasive, safe, painless and easy to perform therapeutic option of BP decrease. As with renal denervation, SBG should be effective in those hypertensive patients with an activated SNS, so a period of patient selection should precede the application of this procedure.