Adrenergic blockade in subarachnoid haemorrhage

Over the last 15 years progressive interest has developed in the relationship between subarachnoid haemorrhage, sympathetic nervous system over-activity and the genesis of cerebral artery spasm. Following on from earlier work, vide infra, suggesting that adrenergic blockade might influence the course and prognosis of patients with subarachnoid haemorrhage, two double blind trials have recently been completed in Southampton. The first trial attempted to establish whether or not a single intracarotid injection of phenoxybenzamine improved the mortality and late morbidity of patients with subarachnoid haemorrhage. Results suggested that it did not. The second trial, comprising two groups of 50 patients each, attempted to assess the influence of prolonged treatment with propranolol on the course and prognosis of these subarachnoid haemorrhage patients. Early results suggest that, as with the alpha-blocker, the mortality and severe morbidity was not improved by beta-adrenergic blockade.