Zhang Yuan, Qian Yanning, Bao Hongguang, Shi Hongwei, Zhou Jianwei
Sheng Wu Yi Xue Gong Cheng Xue Za Zhi. 2016 Feb;33(1):132-5.
The present study was to examine the effect of stellate ganglion block (SGB) on bilateral regional cerebral oxygen saturation (rSO2) and postoperative cognitive function. Eighty patients undergoing selective coronary artery bypass graft with cardiopulmonary bypass (CPB) were randomly and equally divided into two groups. The patients in group S were given right SGB with ropivacaine, while the patients in group C were injected with normal saline. We compared the bilateral rSO2 after SGB. Minimum Mental State Examination (MMSE), Visual Verbal Learning Test (VVLT), and Digital Span Test (DST) were applied to observe the effect on cognitive function. We found that the incidence of postoperative cognitive dysfunction (POCD) 7 days after surgery in group S was lower than that in group C. The level of blocked side rSO₂ of S group were significantly higher before CPB time of rewarming than that before SGB (P < 0.05), much higher than corresponding non-blocked side rSO₂ before CPB (P < 0.05), and much higher than rSO₂ level in group C before CPB and after CPB (P < 0.05). The non-blocked side rSO₂ in group S before anesthesia were much lower than basic levels and those in group C (P < 0.05). It could be concluded from the above results that there was significant increase in the blocked-side rSO₂ compared to the non-blocked side and there was significant decrease in the incidence of POCD compared to the control group after SGB.
本研究旨在探讨星状神经节阻滞(SGB)对双侧局部脑氧饱和度(rSO2)及术后认知功能的影响。80例行体外循环(CPB)下选择性冠状动脉搭桥术的患者被随机等分为两组。S组患者接受右星状神经节罗哌卡因阻滞,C组患者注射生理盐水。我们比较了星状神经节阻滞后双侧的rSO2。采用简易精神状态检查表(MMSE)、视觉言语学习测验(VVLT)和数字广度测验(DST)观察对认知功能的影响。我们发现,S组术后7天的术后认知功能障碍(POCD)发生率低于C组。S组在复温至CPB时间前,阻滞侧rSO₂水平显著高于星状神经节阻滞前(P < 0.05),远高于CPB前相应的非阻滞侧rSO₂(P < 0.05),且远高于C组CPB前后的rSO₂水平(P < 0.05)。S组麻醉前非阻滞侧rSO₂远低于基础水平及C组(P < 0.05)。从上述结果可以得出结论,与非阻滞侧相比,星状神经节阻滞后阻滞侧rSO₂显著升高,与对照组相比,POCD发生率显著降低。