Department of Anesthesiology, Affiliated Hospital of Zunyi Medical University, Zunyi, 550000, Guizhou, China.
Institute of Neurological Disease, Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
Neurol Sci. 2021 Aug;42(8):3121-3133. doi: 10.1007/s10072-021-05300-4. Epub 2021 May 18.
Stellate ganglion block (SGB) has been applied in clinic for almost a century as a therapeutic procedure to alleviate pain-related syndromes and vascular deficits in the upper extremities. A great number of causative side effects and complications due to technological insufficiency and anatomical variations called for the popularity of ultrasound-guided SGB which has made tremendous contribution for clinical diagnosis and therapy, primarily in postoperative pain and cardiac and vascular disorders. This work was aimed at systematically summarizing the current clinical application of ultrasound-guided SGB and putting forward the potential prospective application in future. By searching ultrasound-guided SGB-related works on PubMed database, we mainly elucidated the analgesic effect of preoperative SGB in patients undergoing surgical procedures and substantial reduction in patients with ventricular arrhythmias. The volume of local anesthetics used in ultrasound-guided SGB has been diminished in the recent few years' investigations and successful operation of ultrasound-guided SGB could be achieved with minimal safe volume of local anesthetics. This invasive and safe procedure shows vast potential for future development in clinical treatment for autonomic nervous system and autoimmune disorders. We also put forward hypothesis that ultrasound-guided SGB could be applied combined with controlled hypotension to reduce the intraoperative complications in orthopedic surgery such as insufficiency of cerebral blood flow and reflexive tachycardia. Thus, it is of vital essence to improve the professional skills of physicians for the high rate of success and explore more effective measures which could enhance therapeutic effects when combined with ultrasound-guided SGB in alleviating misery of patients.
星状神经节阻滞 (SGB) 在临床上应用近一个世纪,作为一种治疗方法,可缓解上肢疼痛相关综合征和血管缺陷。由于技术不足和解剖变异引起的大量因果副作用和并发症,需要普及超声引导的 SGB,这为临床诊断和治疗做出了巨大贡献,主要在术后疼痛和心脏和血管疾病方面。本工作旨在系统总结超声引导 SGB 的临床应用现状,并提出未来潜在的应用前景。通过在 PubMed 数据库中搜索与超声引导 SGB 相关的研究,我们主要阐明了术前 SGB 在手术患者中的镇痛效果以及室性心律失常患者的明显减少。近年来的研究表明,在超声引导 SGB 中使用的局部麻醉剂的体积已经减少,并且可以用最小安全剂量的局部麻醉剂成功进行超声引导 SGB 操作。这种有创且安全的操作在治疗自主神经系统和自身免疫性疾病方面具有广阔的发展潜力。我们还提出假设,超声引导 SGB 可以与控制性低血压联合应用,以减少骨科手术中的术中并发症,如脑血流量不足和反射性心动过速。因此,提高医生的专业技能对于提高成功率至关重要,并探索更多有效的措施,以增强超声引导 SGB 在减轻患者痛苦方面的治疗效果。