Department of Anesthesiology, Tohoku University School of Medicine, 1-1 Seiryomachi, Aoba-ku, 980, Sendai, Japan.
J Anesth. 1995 Dec;9(4):338-42. doi: 10.1007/BF02479948.
Since the stellate ganglion contains cardiac sympathetic nerves, stellate ganglion block (SGB) may influence cardiac and coronary hemodynamics. We investigated this influence of SGB by measuring the heart rate (HR), the left circumflex coronary artery blood flow (CBF), the maximum rate of increase of the left ventricular pressure (LV max dP/dt), the cardiac output (CO), the myocardial oxygen consumption (MVO2), and the myocardial oxygen extraction ratio (MOER) in nine dogs before and after performing SGB by means of injection of 2 ml 1% mepivacaine. Left SGB resulted in a decrease of 10% in CBF and a decrease of 15% in LV max dP/dt, but HR, CO, and MVO2 remained unchanged. On the other hand, right SGB resulted in a decrease of 30% in CBF and a decrease of 25% in LV max dP/dt, as well as a decrease of 20% in HR, 15% in CO, and 25% in MVO2. SGB on either side resulted in an increase in MOER that was slight but nonetheless significant (P<0.05) in that it suggested a relative deficit in CBF with respect to MVO2. Inhalation of 100% oxygen decreased MOER to the pre-SGB level in either side, thus improving the myocardial oxygen supply-demand relationship. This study suggests the possibility that SGB has deteriorative effects on the myocardial oxygen supply-demand relationship. Those effects were counteracted by the inhalation of 100% oxygen.
由于星状神经节包含心脏交感神经，星状神经节阻滞（SGB）可能会影响心脏和冠状动脉的血液动力学。我们通过测量心率（HR）、左回旋冠状动脉血流量（CBF）、左心室压力最大上升率（LV max dP/dt）、心输出量（CO）、心肌耗氧量（MVO2）和心肌氧摄取率（MOER）来研究 SGB 的这种影响，在 9 只狗中，通过注射 2ml 1%甲哌卡因来进行左 SGB 和右 SGB。左 SGB 导致 CBF 减少 10%，LV max dP/dt 减少 15%，但 HR、CO 和 MVO2 保持不变。另一方面，右 SGB 导致 CBF 减少 30%，LV max dP/dt 减少 25%，HR 减少 20%，CO 减少 15%，MVO2 减少 25%。SGB 两侧均导致 MOER 轻度但显著增加（P<0.05），这表明 CBF 相对于 MVO2 相对不足。两侧吸入 100%氧气可将 MOER 降低至 SGB 前水平，从而改善心肌氧供需关系。这项研究表明 SGB 可能对心肌氧供需关系产生不利影响。这些影响可通过吸入 100%氧气来抵消。
