Haemodynamic effects of a left stellate ganglion block in ASA I patients. An echocardiographic study.
In anaesthetized dogs, stellate ganglion blockade led to a moderate disturbance in left ventricular diastolic function. We investigated the effect of a left-sided block, following injection of 10 mL bupivacaine 0.5%, on echocardiographic variables of ventricular function in eight otherwise healthy patients with sympathetically mediated pain syndromes. After the blockade, heart rate (control: 66+/-3 (mean+/- SEM), block: 64+/-3 min-1) and mean arterial blood pressure (88.5+/-6.0 vs. 84.0+/-8.1 mmHg) were unchanged, but afterload decreased (end-systolic meridional wall stress; 69.6+/-9.9 vs. 59.8+/-7.1, P < 0.05). Stroke volume increased from 71.2+/-8.1 to 79.6+/-7.4 mL, P < 0.05. Variables of systolic function were unchanged, but relaxation was prolonged (isovolumic relaxation time; 71+/-5 vs. 81+/-4 ms, P < 0.05). In patients who were ASA I, there was a small impairment in echocardiographic variables during ventricular relaxation after a left stellate ganglion blockade. This small effect did not compromise ventricular function, and the heart responded with a small stroke volume increase to the simultaneous afterload reduction.
Schlack
W
W
Institute of Clinical Anaesthesiology, Heinrich-Heine University of Düsseldorf, Düsseldorf, Germany.
Dinter
W
W
D000328:Adult; D000368:Aged; D000779:Anesthetics, Local / Q000008:administration & dosage; D001794:Blood Pressure / Q000502:physiology; D002045:Bupivacaine / Q000008:administration & dosage; D002302:Cardiac Output / Q000502:physiology; D002306:Cardiac Volume / Q000502:physiology; D015150:Echocardiography, Doppler; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000502:physiology; D009407:Nerve Block; D010146:Pain / Q000517:prevention & control; D013233:Stellate Ganglion / Q000502:physiology; D013318:Stroke Volume / Q000502:physiology; D013577:Syndrome; D013599:Systole; D016277:Ventricular Function, Left / Q000502:physiology; D017725:Ventricular Pressure / Q000502:physiology
D000779:Anesthetics, Local; D002045:Bupivacaine