Summary
A series of studies on patients who had suffered a subarachnoid haemorrhage (SAH) demonstrated high urinary catecholamine and plasma cortisol levels over a 3- week period, catecholamine- linked electrocardiographic (ECG) changes (some of which were associated with low total body potassium levels), and the ability of the β- blocker propranolol to reverse some of the ECG abnormalities. In addition, propranolol was shown to prevent the necrotic lesions produced in the myocardium following an SAH.
In this double-blind, placebo-controlled study, 204 patients presenting within 48 hours of an SAH were randomly assigned to 2 groups, 1 receiving standard management only, the other receiving in addition medication with the adrenergic blocking agents propranolol and phentolamine (or propranolol alone) for 3 weeks. The results show that early β- blockade benefits patients with subarachnoid haemorrhage for up to 1 year in terms of lesser neurological deficits and death.
The effects of propranolol and the selective β- blocker, atenolol, on plasma creatinine phosphokinase levels and clinical outcome on a small group of SAH patients suggests that the beneficial effects of β- blockade may be due its prevention of the systemic complications following an SAH.
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Neil-Dwyer, G., Walter, P., Cruickshank, J. et al. β-Blockade in Subarachnoid Haemorrhage. Drugs 25 (Suppl 2), 273–277 (1983). https://doi.org/10.2165/00003495-198300252-00083
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DOI: https://doi.org/10.2165/00003495-198300252-00083