title: Effect of stellate ganglion block on hemodynamics and stress responses during CO2-pneumoperitoneum in elderly patients.
abstract: OBJECTIVE
  Elderly patients undergoing elective laparoscopic cholecystectomy (LC) were given right stellate ganglion block (RSGB) to observe its effects on the hemodynamics and stress response during carbon dioxide (CO2)-pneumoperitoneum.
  
  
  METHODS
  A randomized, single-blinded, and placebo-controlled study.
  
  
  METHODS
  University-affiliated teaching hospital.
  
  
  METHODS
  Sixty patients (aged 65-78years; weight, 45-75kg; American Society of Anesthesiologists (ASA) physical status classification, class I or II) undergoing elective LC.
  
  
  METHODS
  Right stellate ganglion block was performed via C7 access using 10mL of 1% lidocaine in all patients.
  
  
  METHODS
  The patients' heart rate (HR) and mean arterial pressure (MAP) were recorded before the block (T0), 5min following pneumoperitoneum (T1), 30min following pneumoperitoneum (T2), 5min following the deflation of pneumoperitoneum (T3), and upon completion of the surgery (T4). Additionally, the concentrations of epinephrine (E), norepinephrine (NE) and cortisol (COR) were detected in arterial blood at each time point by enzyme-linked immunosorbent assay.
  
  
  RESULTS
  For control group, the MAP and RPP (RPP=SBP×HR) were significantly elevated at T1~3(P<0.05) as compared to T0. Inter-group comparison showed that the MAP, HR and RPP were significantly lower at T1~4in RSGB group (P<0.05 or 0.01). As compared to T0, the E, NE and COR levels significantly rose at T1~4in control group (P<0.05 or 0.01) and COR at T2, 3in RSGB group (P<0.05). The E, NE and COR levels at T1~4were significantly lower in RSGB group as compared to control group (P<0.05 or 0.01).
  
  
  CONCLUSIONS
  Right stellate ganglion block can reduce blood catecholamines during CO2-pneumoperitoneum to maintain perioperative hemodynamic stability and prevent adverse cardiovascular events in elderly patients.
authors.affiliation: Department of Anesthesiology, First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui 241001, China. Electronic address: yongquanchencn@126.com.
authors.forename: Yong-Quan
authors.initials: YQ
authors.lastname: Chen
authors.affiliation: Department of Anesthesiology, First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui 241001, China.
authors.forename: Yu-Yizi
authors.initials: YY
authors.lastname: Xie
authors.affiliation: Department of Anesthesiology, First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui 241001, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Wang
authors.affiliation: Department of Anesthesiology, First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui 241001, China.
authors.forename: Xiao-Ju
authors.initials: XJ
authors.lastname: Jin
mesh_terms: D000368:Aged; D000768:Anesthesia, General; D062186:Arterial Pressure; D001340:Autonomic Nerve Block / Q000379:methods*; D002245:Carbon Dioxide / Q000008:administration & dosage; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects*; D017558:Elective Surgical Procedures / Q000009:adverse effects*; D004797:Enzyme-Linked Immunosorbent Assay; D004837:Epinephrine / Q000097:blood; D005260:Female; D006339:Heart Rate; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D009638:Norepinephrine / Q000097:blood; D019990:Perioperative Care / Q000379:methods; D011028:Pneumoperitoneum, Artificial / Q000009:adverse effects*; D013233:Stellate Ganglion / Q000187:drug effects*
chemical_list: D002245:Carbon Dioxide; D008012:Lidocaine; D006854:Hydrocortisone; D009638:Norepinephrine; D004837:Epinephrine
keywords: Block; Carbon dioxide-pneumoperitoneum; Elderly patients; Hemodynamics; Stellate ganglion; Stress response