Effects of ultrasound-guided stellate ganglion block on autonomic nervous function during CO2-pneumoperitoneum: A randomized double-blind control trial.
BACKGROUND
CO2-pneumoperitoneum can cause sympathetic nerve activity increased and is likely to causes severe stress-related homeostatic disorders.


OBJECTIVE
Patients undergoing elective laparoscopic cholecystectomy were administered type-B ultrasound-guided stellate ganglion block (SGB) to observe the effects on autonomic nervous system during CO2- pneumoperitoneum.


METHODS
A randomized, double-blinded, and placebo-controlled study.


METHODS
University-affiliated teaching hospital.


METHODS
Eighty patients (aged 32-75 years; weight, 45-80 kg; American Society of Anesthesiologists (ASA) physical status classification, class I or II) undergoing elective laparoscopic cholecystectomy.


METHODS
The RSGB group was administered lidocaine 1% 7 ml under ultrasound guidance.


METHODS
The low frequency (LF), high frequency (HF), total power (TP) and LF/HF ratio were recorded before the block (T0), 5 min (T1) and 30 min (T2) following pneumoperitoneum, 5 min after deflation of pneumoperitoneum (T3) and after surgery (T4). The low-frequency normalized unit (LFnu) and high-frequency normalized units (HFnu) were calculated.


RESULTS
Compared with T0, LF, LFnu and LF/HF ratio were significantly elevated at T1-4 (all P< .05 or .01). HFnu was significantly decreased at T2-4 in control group (P< .05) while HF was significantly elevated (P< .01). The LF/HF ratio was significantly decreased (P< .05) at T1-4 in RSGB group. Compared with control group, the LF, LFnu and LF/HF ratio were significantly decreased (P< .05) and HF and HFnu was significantly elevated (P< .05 or .01) at T1-4 in RSGB group.


CONCLUSIONS
Ultrasound-guided RSGB inhibited CO2-pneumoperitoneum-induced sympathetic neural excitation, upregulated vagal nerve stimulation and maintained stable autonomic nervous function.
Department of Anesthesiology, First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui 241001, China. Electronic address: yongquanchencn@126.com.
Yongquan
Y
Chen
Department of Anesthesiology, First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui 241001, China.
Yuyizi
Y
Xie
Department of Anesthesiology, First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui 241001, China.
Yurong
Y
Xue
Department of Anesthesiology, First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui 241001, China.
Bin
B
Wang
Department of Anesthesiology, First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui 241001, China.
Xiaoju
X
Jin
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000772:Anesthesia, Local / Q000009:adverse effects; D001340:Autonomic Nerve Block / Q000379:methods*; D001341:Autonomic Nervous System / Q000187:drug effects; D002245:Carbon Dioxide; D017081:Cholecystectomy, Laparoscopic; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D011027:Pneumoperitoneum; D013233:Stellate Ganglion; D018084:Ultrasonography, Interventional / Q000379:methods*
D002245:Carbon Dioxide; D008012:Lidocaine
Autonomic nerve; CO(2)-pneumoperitoneum; Heart rate variability; Stellate ganglion blockade; Type-B ultrasound