Nagahara M, Tamaki Y, Araie M, Umeyama T
Department of Ophthalmology, University of Tokyo School of Medicine, Japan.
Acta Ophthalmol Scand. 2001 Feb;79(1):45-8. doi: 10.1034/j.1600-0420.2001.079001045.x.
To study the acute effects of local-anesthetic stellate ganglion block (SGB) on tissue circulation in the human fundus.
Eleven patients with Bell's palsy (age 56+/-6 y, mean+/-SD) who underwent SGB for its treatment participated in the study. Using the laser speckle method, normalized blur (NB) value, a quantitative index of tissue blood velocity, was measured every 0.125 s over an area located halfway between the macula and the optic nerve head (ONH) with no discrete visible vessels and averaged over 3 pulses when fixation was satisfactory (NB(ch-ret)). NB(ch-ret) and intraocular pressure (IOP) in both eyes, blood pressure (BP), and pulse rate (PR) were measured before, and 10, 20, 30, and 60 min after SGB. SGB was induced by injecting 1% mepivacaine hydrochloride (5 ml) into the vicinity of the seventh cervical vertebra on the paralyzed side.
The IOP in the blocked side significantly decreased between 20 and 60 min following SGB, compared to the baseline, while IOP in the unblocked side remained unchanged. The NB(ch-ret) was significantly increased after 10 min by about 8% in the blocked side, but its effect almost disappeared at 60 min. There was no significant change in NB(ch-ret) in the unblocked side, BP or PR throughout the experimental period.
SGB increased tissue circulation in the fundus in the blocked side, but its effect was thought to be small and transient.
研究局部麻醉星状神经节阻滞（SGB）对人眼底组织循环的急性影响。
11例因贝尔麻痹（年龄56±6岁，均值±标准差）接受SGB治疗的患者参与了本研究。采用激光散斑法，在黄斑与视神经乳头（ONH）之间中点处一个无可见离散血管的区域，每0.125秒测量一次归一化模糊（NB）值（一种组织血流速度的定量指标），当注视良好时对3个脉冲的测量值进行平均（NB（ch-ret））。在SGB前以及SGB后10、20、30和60分钟测量双眼的NB（ch-ret）和眼压（IOP）、血压（BP）及脉搏率（PR）。通过在瘫痪侧第七颈椎附近注射1%盐酸甲哌卡因（5毫升）诱导SGB。
与基线相比，SGB后20至60分钟时，阻滞侧的IOP显著降低，而未阻滞侧的IOP保持不变。阻滞侧在10分钟后NB（ch-ret）显著增加约8%，但在60分钟时其作用几乎消失。在整个实验期间，未阻滞侧的NB（ch-ret）、BP或PR均无显著变化。
SGB增加了阻滞侧眼底的组织循环，但其作用被认为较小且短暂。
