title: Effects of bilateral stellate ganglion block on autonomic cardiovascular regulation.
abstract: 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.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Jun-Gol
authors.initials: JG
authors.lastname: Song
authors.forename: Gyu-Sam
authors.initials: GS
authors.lastname: Hwang
authors.forename: Eun Ho
authors.initials: EH
authors.lastname: Lee
authors.forename: Jeong Gil
authors.initials: JG
authors.lastname: Leem
authors.forename: Chung
authors.initials: C
authors.lastname: Lee
authors.forename: Pyung Hwan
authors.initials: PH
authors.lastname: Park
authors.forename: Jin Woo
authors.initials: JW
authors.lastname: Shin
mesh_terms: 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
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine