Department of Anesthesiology, First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui 241001, China.
Department of Anesthesiology, First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui 241001, China.
J Clin Anesth. 2017 Feb;37:149-153. doi: 10.1016/j.jclinane.2016.12.003. Epub 2017 Jan 10.
Elderly patients undergoing elective laparoscopic cholecystectomy (LC) were given right stellate ganglion block (RSGB) to observe its effects on the hemodynamics and stress response during carbon dioxide (CO)-pneumoperitoneum.
A randomized, single-blinded, and placebo-controlled study.
University-affiliated teaching hospital.
Sixty patients (aged 65-78years; weight, 45-75kg; American Society of Anesthesiologists (ASA) physical status classification, class I or II) undergoing elective LC.
Right stellate ganglion block was performed via C7 access using 10mL of 1% lidocaine in all patients.
The patients' heart rate (HR) and mean arterial pressure (MAP) were recorded before the block (T), 5min following pneumoperitoneum (T), 30min following pneumoperitoneum (T), 5min following the deflation of pneumoperitoneum (T), and upon completion of the surgery (T). Additionally, the concentrations of epinephrine (E), norepinephrine (NE) and cortisol (COR) were detected in arterial blood at each time point by enzyme-linked immunosorbent assay.
For control group, the MAP and RPP (RPP=SBP×HR) were significantly elevated at T (P<0.05) as compared to T. Inter-group comparison showed that the MAP, HR and RPP were significantly lower at T in RSGB group (P<0.05 or 0.01). As compared to T, the E, NE and COR levels significantly rose at T in control group (P<0.05 or 0.01) and COR at T in RSGB group (P<0.05). The E, NE and COR levels at T were significantly lower in RSGB group as compared to control group (P<0.05 or 0.01).
Right stellate ganglion block can reduce blood catecholamines during CO-pneumoperitoneum to maintain perioperative hemodynamic stability and prevent adverse cardiovascular events in elderly patients.
对行择期腹腔镜胆囊切除术（LC）的老年患者进行右侧星状神经节阻滞（RSGB），观察其在二氧化碳（CO）气腹期间对血液动力学和应激反应的影响。
随机、单盲、安慰剂对照研究。
大学附属医院。
60 名（年龄 65-78 岁；体重 45-75kg；美国麻醉医师协会（ASA）体格状况分类，I 或 II 级）接受择期 LC 的患者。
所有患者均通过 C7 入路进行右侧星状神经节阻滞，使用 1%利多卡因 10mL。
在阻滞前（T）、气腹后 5 分钟（T）、气腹后 30 分钟（T）、气腹放气后 5 分钟（T）和手术结束时（T）记录患者的心率（HR）和平均动脉压（MAP）。此外，通过酶联免疫吸附试验在动脉血中检测每个时间点肾上腺素（E）、去甲肾上腺素（NE）和皮质醇（COR）的浓度。
与 T 相比，对照组 T 时 MAP 和 RPP（RPP=SBP×HR）显著升高（P<0.05）。组间比较显示，RSGB 组 T 时 MAP、HR 和 RPP 显著降低（P<0.05 或 0.01）。与 T 相比，对照组 T 时 E、NE 和 COR 水平显著升高（P<0.05 或 0.01），RSGB 组 T 时 COR 水平升高（P<0.05）。与对照组相比，RSGB 组 T 时 E、NE 和 COR 水平显著降低（P<0.05 或 0.01）。
右侧星状神经节阻滞可减少 CO 气腹期间的血液儿茶酚胺，维持围手术期血液动力学稳定，预防老年患者心血管不良事件。
