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[星状神经节阻滞在特发性面神经麻痹中的循环效应]

[Circulatory effects of stellate ganglion block in idiopathic facial palsy].

作者信息

Murakawa K, Ishimoto E, Noma K, Ishida K, Nishijima M, Izumi R

机构信息

Department of Anesthesiology, Hyogo College of Medicine, Nishinomiya.

出版信息

Masui. 1994 Mar;43(3):356-60.

PMID:8182880
Abstract

The circulatory effects of stellate ganglion block (SGB) on the blood flow through the common carotid artery were determined in 35 patients in acute phase of idiopathic facial palsy (Bell's palsy). SGB was performed by para-tracheal approach with 8 ml of 1% mepivacaine. The blood flow was measured with an ultrasonic blood flowmeter before and 30 minutes after SGB at both sides of the common carotid artery in 20 cases. Measurement was performed continuously for 90 minutes on the palsy side in the other 15 patients. Before SGB, there were no significant differences between the blood flow of the palsy side and the intact side. Thirty minutes after SGB, the blood flow markedly increased to 169.4 +/- 6.2% on the performed side with no change on the non-performed side in 20 cases. In the other 15 patients, the blood flow increased significantly 5 minutes after SGB and reached its peak of 179.7 +/- 11.1% at 20 minutes later. This increase continued for 75 minutes after SGB. It is well known that impaired microcirculation in the facial nerve has an important role in the pathophysiology of Bell's palsy. In view of the fact that the nutrient arteries for the facial nerve are the peripheral branches of the external carotid artery, we believe that SGB which causes significant increase in the blood flow through the common carotid artery is an effective treatment in Bell's palsy.

摘要

在35例特发性面神经麻痹(贝尔麻痹)急性期患者中,测定了星状神经节阻滞(SGB)对颈总动脉血流的循环影响。采用气管旁入路,用8毫升1%的甲哌卡因进行SGB。在20例患者中,于SGB前及SGB后30分钟,用超声血流仪测量双侧颈总动脉的血流。在另外15例患者中,对麻痹侧连续测量90分钟。SGB前,麻痹侧与健侧的血流无显著差异。在20例患者中,SGB后30分钟,实施阻滞侧的血流显著增加至169.4±6.2%,未实施阻滞侧无变化。在另外15例患者中,SGB后5分钟血流显著增加,并在20分钟后达到峰值179.7±11.1%。SGB后这种增加持续75分钟。众所周知,面神经微循环受损在贝尔麻痹的病理生理学中起重要作用。鉴于面神经的营养动脉是颈外动脉的外周分支,我们认为能使颈总动脉血流显著增加的SGB是贝尔麻痹的一种有效治疗方法。

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