Wu Zhen, Cai Hong-Qin, Wang Chun-Feng, Yu Xiang-Yuan, Wang Jie-Qiong
Department of Anesthesiology, The Kunshan Second People's Hospital, Kunshan 215300, Jiangsu Province, China.
World J Gastrointest Surg. 2024 Sep 27;16(9):2961-2967. doi: 10.4240/wjgs.v16.i9.2961.
Stellate ganglion block is a commonly used sympathetic nerve block technique that restores the balance of the sympathetic and vagal nervous systems of the body and inhibits sympathetic nerve activity.
To analyze the effect of a stellate ganglion block combined with total diploma intravenous anesthesia on postoperative pain and immune function in patients undergoing laparoscopic radical gastric cancer (GC) surgery to provide a reference basis for the formulation of anesthesia protocols for radical GC surgery.
This study included 112 patients who underwent laparoscopic radical surgery for GC between January 2022 and March 2024. There was no restriction on sex. The patient grouping method used was a digital random table method, and the number of cases in each group was 56. The control group was administered total intravenous anesthesia, and the observation group compounded the stellate ganglion block according to the total intravenous anesthesia protocol. Postoperative hemodynamics, pain levels, and immune indices were compared between the groups.
The heart rate and mean arterial pressure in the observation group after intubation were lower than those in the control group ( < 0.05). Pain levels were compared between the two groups at 2 hours, 12 hours, 24 hours, and 48 hours after surgery ( > 0.05). The number of CD3, CD4, and CD4/CD8 cells at the end of surgery was higher in the observation group than in the control group, and the number of CD8 cells was lower in the observation group than in the control group ( < 0.05). There were no significant differences between the two groups in terms of propofol dosage, awakening time, extubation time, or postoperative adverse reactions ( > 0.05).
The application of a stellate ganglion block combined with total intravenous anesthesia had no significant effect on postoperative pain levels in patients undergoing laparoscopic radical GC surgery. However, it can safely reduce the effect of surgery on the immune function of patients and is worth applying in clinical practice.
星状神经节阻滞是一种常用的交感神经阻滞技术,可恢复机体交感神经与迷走神经系统的平衡并抑制交感神经活动。
分析星状神经节阻滞联合全凭静脉麻醉对腹腔镜根治性胃癌(GC)手术患者术后疼痛及免疫功能的影响,为根治性GC手术麻醉方案的制定提供参考依据。
本研究纳入2022年1月至2024年3月期间行腹腔镜根治性GC手术的112例患者,性别不限。采用数字随机表法进行患者分组,每组病例数为56例。对照组采用全凭静脉麻醉,观察组在全凭静脉麻醉方案基础上复合星状神经节阻滞。比较两组术后血流动力学、疼痛程度及免疫指标。
观察组插管后心率和平均动脉压低于对照组(P<0.05)。术后2小时、12小时、24小时和48小时比较两组疼痛程度(P>0.05)。观察组手术结束时CD3、CD4及CD4/CD8细胞数量高于对照组,CD8细胞数量低于对照组(P<0.05)。两组在丙泊酚用量、苏醒时间、拔管时间及术后不良反应方面比较,差异无统计学意义(P>0.05)。
星状神经节阻滞联合全凭静脉麻醉对腹腔镜根治性GC手术患者术后疼痛程度无显著影响。然而,其可安全减轻手术对患者免疫功能的影响,值得临床应用。