Gulcu Nebahat, Gonca Ersoz, Kocoglu Hasan
Department of Anesthesiology, Abant Izzet Baysal University, Bolu, Turkey.
Anesth Analg. 2009 May;108(5):1701-4. doi: 10.1213/ane.0b013e31819c6018.
In the present study, we describe and show the efficacy of a lateral approach to stellate ganglion block (SGB) in rats.
Twenty-one rats were randomized into three groups: the posterior technique group (n = 7), the lateral technique group (n = 7), and the control group (n = 7). Thiopental was administered intraperitonally as 5 mg per 100 g of each rat's weight for sedation during the procedure. In the posterior technique group, SGB was performed by a posterior percutaneous approach as described previously. In the lateral technique and control groups, the cervical vertebrae was fixed between the left first and third fingers of the physician's left hand while palpating the C7 process with the second finger. The study drug was 0.2 mL 0.25% plain bupivacaine for the two percutaneous treatment groups, and 0.2 mL saline in the controls.
Two animals in the posterior technique group died immediately after local anesthetic injection (P < 0.01). There were no deaths in the new technique group or in the controls. Ptosis appeared at 300 +/- 120 s in the posterior group, whereas it was seen almost immediately after withdrawing the needle in the lateral technique group (6 +/- 4 s) (P < 0.001). Ptosis did not occur in the control group. There was no statistically significant difference in heart rate among groups (P > 0.069).
The lateral approach to SGB does not require the induction of general anesthesia. The approach is associated with early development of ptosis and may be associated with a lower mortality rate compared to the conventional posterior approach.
在本研究中,我们描述并展示了大鼠星状神经节阻滞(SGB)外侧入路的有效性。
将21只大鼠随机分为三组:后路技术组(n = 7)、外侧技术组(n = 7)和对照组(n = 7)。在操作过程中,以每只大鼠体重每100 g腹腔注射5 mg硫喷妥钠进行镇静。后路技术组采用如前所述的后路经皮入路进行SGB。在外侧技术组和对照组中,术者左手的食指触诊C7棘突时,用左手的食指和中指将颈椎固定在第一和第三指之间。两个经皮治疗组的研究药物为0.2 mL 0.25%的布比卡因原液,对照组为0.2 mL生理盐水。
后路技术组有2只动物在局部麻醉药注射后立即死亡(P < 0.01)。新技术组和对照组均无死亡。后路组在300±120秒时出现上睑下垂,而外侧技术组在拔出针头后几乎立即出现上睑下垂(6±4秒)(P < 0.001)。对照组未出现上睑下垂。各组间心率无统计学差异(P > 0.069)。
SGB外侧入路无需全身麻醉诱导。与传统的后路入路相比,该入路与上睑下垂的早期出现有关,且可能与较低的死亡率有关。