The acute effects of stellate ganglion block on circulation in human ocular fundus.
OBJECTIVE
To study the acute effects of local-anesthetic stellate ganglion block (SGB) on tissue circulation in the human fundus.


METHODS
Eleven patients with Bell's palsy (age 56+/-6 y, mean+/-SD) who underwent SGB for its treatment participated in the study. Using the laser speckle method, normalized blur (NB) value, a quantitative index of tissue blood velocity, was measured every 0.125 s over an area located halfway between the macula and the optic nerve head (ONH) with no discrete visible vessels and averaged over 3 pulses when fixation was satisfactory (NB(ch-ret)). NB(ch-ret) and intraocular pressure (IOP) in both eyes, blood pressure (BP), and pulse rate (PR) were measured before, and 10, 20, 30, and 60 min after SGB. SGB was induced by injecting 1% mepivacaine hydrochloride (5 ml) into the vicinity of the seventh cervical vertebra on the paralyzed side.


RESULTS
The IOP in the blocked side significantly decreased between 20 and 60 min following SGB, compared to the baseline, while IOP in the unblocked side remained unchanged. The NB(ch-ret) was significantly increased after 10 min by about 8% in the blocked side, but its effect almost disappeared at 60 min. There was no significant change in NB(ch-ret) in the unblocked side, BP or PR throughout the experimental period.


CONCLUSIONS
SGB increased tissue circulation in the fundus in the blocked side, but its effect was thought to be small and transient.
Nagahara
M
M
Department of Ophthalmology, University of Tokyo School of Medicine, Japan.
Tamaki
Y
Y
Araie
M
M
Umeyama
T
T
D000779:Anesthetics, Local; D001340:Autonomic Nerve Block; D020330:Bell Palsy / Q000503:physiopathology* / Q000601:surgery; D001775:Blood Circulation; D001783:Blood Flow Velocity; D001794:Blood Pressure / Q000502:physiology; D005260:Female; D005654:Fundus Oculi; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D017078:Laser-Doppler Flowmetry; D008297:Male; D008619:Mepivacaine; D008875:Middle Aged; D012171:Retinal Vessels / Q000503:physiopathology*; D013233:Stellate Ganglion / Q000503:physiopathology*
D000779:Anesthetics, Local; D008619:Mepivacaine