Effects of bilateral stellate ganglion block on autonomic cardiovascular regulation.
BACKGROUND
Stellate ganglion block (SGB) is performed for the diagnosis and treatment of sympathetic dependent pain in the head, neck and upper limbs. However, the effects of bilateral SGB on cardiovascular and autonomic regulation remain unknown. The aim of this study was to assess the effects of bilateral SGB on cardiovascular and autonomic function by measuring heart rate variability (HRV), systolic blood pressure variability (SBPV) and spontaneous baroreflex sensitivity (SBRS).


RESULTS
Twenty healthy volunteers were randomly allocated to receive right or left SGB with 8 ml 1% lidocaine solution; after 20 min, the contralateral side SGB was performed. Changes in the RR interval (RRI), systolic blood pressure (SBP), HRV, SBPV and SBRS were assessed before and after bilateral SGB. The low-frequency (LF, 0.04-0.15 Hz) and high-frequency (HF, 0.15-0.4 Hz) components of HRV and SBRS decreased significantly; however, no significant changes were found in RRI, SBP and the LF and HF components of SBPV after bilateral SGB. In subjects with symptoms of vagal blockade, HRV, SBP and SBRS were significantly affected by bilateral SGB.


CONCLUSIONS
Bilateral SGB should be performed cautiously because it can reduce cardiac vagal modulation and BRS, especially for those with symptoms of vagal blockade after bilateral SGB.
Song
Jun-Gol
JG
Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Hwang
Gyu-Sam
GS
Lee
Eun Ho
EH
Leem
Jeong Gil
JG
Lee
Chung
C
Park
Pyung Hwan
PH
Shin
Jin Woo
JW
D000328:Adult; D000779:Anesthetics, Local / Q000008:administration & dosage*; D001340:Autonomic Nerve Block; D017704:Baroreflex / Q000187:drug effects*; D001794:Blood Pressure / Q000187:drug effects; D002319:Cardiovascular System / Q000294:innervation*; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D013233:Stellate Ganglion / Q000187:drug effects*; D013997:Time Factors; D014630:Vagus Nerve / Q000187:drug effects*; D055815:Young Adult
D000779:Anesthetics, Local; D008012:Lidocaine