Author Agent and application Patient collective Results Methodical side effects Pharmacological side effects Remark Thomas et al., [90] SNP via EVD or cisternal catheter Group 1: 7-88 mg SNP until improvement of spasm or occurrence of side effect Group 2: 4-8 mg SNP every 6 hours for 5-17 days Group 1: 15 patients with refractory vasospasm Group 2: 10 patients prophylactically (Fisher grade 3, Hunt/Hess grade 3-5) Group 1: improvement of angiographic vasospasm in 8 patients Group 2: no signs of vasospasm None Group 1: hypotension in 3 cases, nausea in 2 cases Group 2: None No controlled study, not randomised Thomas et al., [91] SNP+Thiosulfat via EVD (4 mg/ml und 10 mg/ml) “acute protocol”: 10 ml in 10 single doses every 5 minutes “prophylactic protocol”: 2 ml over 60 minutes for 11-14 days “acute protocol”: 10 patients with DIND or elevated flow velocities in TCD “prophylactic protocol”: 6 patients Improvement of DIND and flow velocities in TCD in 9/10 cases None None No controlled study Raabe et al., [92] SNP via EVD or cisternal catheter single bolus 10-40 mg (11 patients) continuous infusion 2-8 mg for 7-14 days 13 patients with refractory vasospasm Tissue oxygenation improved in 6 patients with vasospasm None Hypotension in 5 cases, nausea in 3 cases, cardiac arrhythmias in 1 case No controlled study, not randomized Pathak et al., [93] SNP “high-dose” (5 mg every 4-12 hours via EVD) SNP “low-dose” (4 mg every 6 hours via cisternal catheter “high-dose”: 5 patients with DIND “low-dose”: 3 patients with SAH Fisher grade 3 reduction of flow velocity in TCD No spasm in 2, moderate spasm in 1 prophylactically treated patients None Distinct hypotension after administration of SNP Not randomised Kumar et al., [94] SNP via EVD Repeated administration of 4 mg bolus 10 patients with SAH improvement or complete recovery of vasospasm in all patients None Nausea in higher doses, hypotension in 2 cases No controlled study, not randomized

Table 2: Clinical trials assessing the effects of intrathecal administration of sodium nitroprussid in patients with refractory vasospasm and patients with high risk to develop vasospasm and DCI (SNP=sodium nitroprussid, EVD=external ventricular catheter, TCD=transcranial Doppler sonography).