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For: Chen YQ, Jin XJ, Liu ZF, Zhu MF. Effects of stellate ganglion block on cardiovascular reaction and heart rate variability in elderly patients during anesthesia induction and endotracheal intubation. J Clin Anesth. 2015;27:140-145. [PMID: 25559299 DOI: 10.1016/j.jclinane.2014.06.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2013] [Revised: 05/19/2014] [Accepted: 06/09/2014] [Indexed: 12/25/2022]

For:	Chen YQ, Jin XJ, Liu ZF, Zhu MF. Effects of stellate ganglion block on cardiovascular reaction and heart rate variability in elderly patients during anesthesia induction and endotracheal intubation. J Clin Anesth. 2015;27:140-145. [PMID: 25559299 DOI: 10.1016/j.jclinane.2014.06.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2013] [Revised: 05/19/2014] [Accepted: 06/09/2014] [Indexed: 12/25/2022]

Number

Cited by Other Article(s)

Liu Y, Piao G, Chen J, Duan G, Dan L, Chen G, Zhang Y. Effect of Right Stellate Ganglion Block on Preventing Postoperative Nausea and Vomiting in Gynecological Laparoscopic Patients: A Randomized Controlled Trial. Adv Ther 2025;42:1537-1549. [PMID: 39928244 DOI: 10.1007/s12325-025-03109-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2024] [Accepted: 01/14/2025] [Indexed: 02/11/2025]

Abstract

INTRODUCTION

Postoperative nausea and vomiting (PONV) is one of the most common postoperative complications, with particularly high rates in patients undergoing high-risk surgeries such as gynecologic laparoscopy. Although there are many pharmacological and non-pharmacological methods that can prevent PONV, the incidence remains high. This study assessed the effectiveness of a right stellate ganglion block (SGB) in preventing PONV in gynecological laparoscopy patients, while also exploring the potential mechanisms involved.

METHODS

Two hundred patients were randomly assigned to either a right SGB under ultrasound guidance 30 min before anesthesia (SGB group) or no treatment (control group). The primary outcome was PONV incidence within 24 h post surgery. Secondary outcomes included nausea and vomiting severity, pain scores, postoperative flatus time, sleep quality, and satisfaction scores.

RESULTS

The incidence of PONV in the SGB group was 38%, significantly lower than the 60% in the control group (P = 0.002). Severity of PONV was also notably reduced in the SGB group (P = 0.004). Resting pain scores in the SGB group at 6 h (0.0 [0.0, 1.0] vs. 0.0 [0.0, 2.0], P = 0.013), 12 h (0.0 [0.0, 1.0] vs. 0.0 [0.0, 2.0], P = 0.027), and 24 h (0.0 [0.0, 1.0] vs. 0.0 [0.0, 2.0], P = 0.011) were lower than in the control group. Post-activity pain scores at 6 h (2.0 [1.0, 3.0] vs. 3.0 [1.25, 4.0], P = 0.000), 12 h (2.0 [1.0, 3.0] vs. 3.0 [1.25, 4.0], P = 0.002), and 24 h (2.0 [1.0, 3.0] vs. 3.0 [2.0, 4.0], P = 0.001) were also lower. The time to first postoperative flatus was shorter in the SGB group (P = 0.033). Overall postoperative satisfaction (P = 0.002) and analgesia satisfaction (P = 0.002) were higher, and sleep quality was improved (P = 0.046).

CONCLUSION

A right stellate ganglion block reduces PONV, pain, and postoperative flatus time, and improves sleep quality and satisfaction in gynecological laparoscopy patients, proving it to be a safe and effective method.

TRIAL REGISTRATION

NCT06426186.

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Duan Q, Zhang H, Zhao K, Hu H, Zhou Y, Yang D. Stellate ganglia block reduces airway hyperresponsiveness with modulates the IKK/NF-κB/IL-4/IL-5/IL-13 pathway. Respir Res 2025;26:65. [PMID: 39985034 PMCID: PMC11846312 DOI: 10.1186/s12931-025-03131-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2024] [Accepted: 01/31/2025] [Indexed: 02/23/2025] Open

Abstract

BACKGROUND

Airway hyperresponsiveness (AHR) is characterized by excessive contraction of airway smooth muscle, leading to airflow limitation, increasing perioperative airway spasm and even triggering the defense of silent lungs, which can lead to delayed surgery. Stellate ganglion blockade (SGB) has gained attention for its immunomodulatory and anti-inflammatory effects; however, its impact on AHR and the underlying mechanisms remain unexplored. This study aims to evaluate whether SGB reduces AHR and if this effect is related to inflammation.

METHODS

The experimental groups included Control, OVA (ovalbumin-induced AHR), OVA + SGB2, OVA + SGB4, OVA + SGB5, OVA + SGB6, OVA + SGB8, OVA + 4PBA, Tm, and Tm + SGB6. Mice underwent varying numbers of SGB interventions over 17 days. On day 18, lung function tests were performed, followed by ELISA of IL-4, IL-5, and IL-13 levels in alveolar lavage fluid from the right lung, and finally, tissue from the right lung was extracted for transcriptome analysis, and tissue from the left lung (without lavage fluid) was stained with HE staining to assess histopathological changes.

RESULTS

Compared to the Control group, the OVA group exhibited increased overall respiratory resistance (Rrs), overall respiratory elasticity (Ers), central airway resistance (Rn), peripheral tissue elasticity (H), and tissue damage (G), alongside decreased overall respiratory compliance (Crs) (P < 0.05). SGB significantly improved lung function parameters, with the OVA + SGB6 group showing the most pronounced improvement (P < 0.05). The Tm group displayed elevated Rrs compared to Control (P < 0.05), while the OVA + 4PBA group demonstrated significant improvement in Rrs (P < 0.05). The Tm + SGB6 group also showed significant improvement in Rrs compared to the Tm group (P < 0.05). The expression of IRE1β-IKK/NF-κB genes was upregulated in the OVA group and downregulated in the OVA + SGB6 group. Furthermore, ER stress inhibitors reduced the expression of these key genes in OVA-induced AHR. Notably, the expression of ER stress-related genes was elevated in the OVA group, with a significant decrease in Agr2 (a promoter of ER stress IRE1β) observed in the OVA + SGB6 group compared to the OVA group (114 vs. 16).

CONCLUSION

SGB effectively reduced AHR while down-regulating the expression of key genes in the IKK/NF-κB/IL-4/IL-5/IL-13 signaling pathway, which may be related to IRE1β-mediated endoplasmic reticulum stress. However, further studies are needed to confirm the exact mechanism.

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Wei Y, Xiong J, Li X, Ling F, Zhao Y, Sun Y, Yao J, Hu J, Yang L, Liu Y, Qi W, Liang F. Efficacy and Safety of Stellate Ganglion Block for Treating Angina Pectoris: A Systematic Review and Meta-Analysis. Cardiovasc Ther 2025;2025:7134878. [PMID: 39980940 PMCID: PMC11842144 DOI: 10.1155/cdr/7134878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2024] [Accepted: 01/03/2025] [Indexed: 02/22/2025] Open

Abstract

Purpose: This systematic review and meta-analysis of randomized controlled trials (RCTs) is aimed at assessing the clinical efficacy and safety of stellate ganglion block (SGB) for angina pectoris (AP). Methods: PubMed, Embase, Cochrane Library, Web of Science, Chinese National Knowledge Infrastructure, China Science and Technology Journal Database, and Wanfang databases were comprehensively searched for RCTs investigating SGB treatment for AP. The retrieval time was from the establishment date of each database to October 10, 2024. The Cochrane risk of bias assessment tool was used to determine the methodological quality. Review Manager 5.4 software was employed for data analysis, and GRADEpro GDT software was utilized to evaluate the quality of evidence. Results: Ultimately, six RCTs were included, encompassing 373 patients with angina. The overall methodological quality of the included studies was moderate, with the evaluation of evidence quality showing 12 low-quality and five extremely low-quality studies. The meta-analysis results demonstrated that compared with the control group, the experimental group had lower frequency and duration of AP, visual analog scale score, heart rate, detection rate of S-T segment elevation ≥ 0.1 mV on electrocardiogram (ECG) after 24 h of treatment, detection rate of abnormal T waves on ECG after 24 h of treatment, and S-T segment displacement on ECG after treatment. Furthermore, the experimental group exhibited lower serum Cardiac Troponin I levels, a decreased incidence of acute myocardial infarction (AMI) and rehospitalization, and improved clinical efficacy. However, none of the included studies reported SGB-related adverse events. Conclusion: SGB is effective in alleviating myocardial injury and reducing the incidence of AMI and rehospitalization in patients with AP. Nevertheless, the limited number and relatively low quality of included studies emphasize the requirement for more high-quality research to verify these conclusions.

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Wu W, Dai H, Liu M, Liu Y, Shi H. Effect of stellate ganglion block on perioperative myocardial injury following thoracoscopic surgery for lung cancer (SGBMI): protocol for a single-centre, randomised controlled trial. BMJ Open Respir Res 2024;11:e002446. [PMID: 39645237 PMCID: PMC11624790 DOI: 10.1136/bmjresp-2024-002446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 11/12/2024] [Indexed: 12/09/2024] Open

Zhou C, Huang X, Zhuo Z, Wu Q, Liu M, Li S. Effect of different anesthesia depths on perioperative heart rate variability and hemodynamics in middle-aged and elderly patients undergoing general anesthesia. BMC Anesthesiol 2024;24:312. [PMID: 39243005 PMCID: PMC11378510 DOI: 10.1186/s12871-024-02700-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 08/26/2024] [Indexed: 09/09/2024] Open

Abstract

BACKGROUND

To analyze the effects of different anesthesia depths on perioperative heart rate variability and hemodynamics in middle-aged and elderly patients undergoing general anesthesia, and to provide a basis for clinical application.

METHODS

A total of 111 patients with gastric cancer who were treated with epidural anesthesia combined with general anesthesia were selected as the study subjects, and the patients were randomly divided into group A, group B and group C. The bispectral index (BIS) was maintained by adjusting the infusion speed of anesthetics, the BIS of group A was maintained at 50 ~ 59, the BIS of group B was maintained at 40 ~ 49, and the BIS of group C was maintained at 30 ~ 39. The high-frequency power (HFP), low-frequency power (LFP), total power (TP), mean arterial pressure (MAP), heart rate (HR), diastolic blood pressure (DBP), and systolic blood pressure (SBP) were measured before anesthesia induction (T1), immediately after intubation (T2), 3 min after intubation (T3), and 6 min after extubation (T4). The cognitive function of the patients was evaluated before and 48 h after surgery.

RESULTS

The HFP, LFP/HFP, TP, HR, DBP and SBP between the three groups at T1 ~ T3 are significantly difference from each other (P < 0.05). There were significant differences in spontaneous breathing recovery time, eye opening time and extubation time among group A, B and C groups, and group B had the lowest spontaneous breathing recovery time, eye opening time and extubation time (P < 0.05). There was no significant difference in the incidence of adverse reactions during anesthesia between the three groups. The cognitive function score of group B was significantly higher than that of group A and group C (P < 0.05).

CONCLUSIONS

BIS maintenance of 40 ~ 49 has little effect on perioperative heart rate variability and hemodynamics in middle-aged and elderly patients undergoing general anesthesia, which is helpful for postoperative recovery.

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Hu Z, Li W, Zhao G, Liang C, Li K. Postoperative stellate ganglion block to reduce myocardial injury after laparoscopic radical resection for colorectal cancer: protocol for a randomised trial. BMJ Open 2023;13:e069183. [PMID: 37977873 PMCID: PMC10660892 DOI: 10.1136/bmjopen-2022-069183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 10/31/2023] [Indexed: 11/19/2023] Open

Abstract

INTRODUCTION

Stellate ganglion block (SGB) is usually used in the department of algiatry. But preoperative SGB may reduce adverse cardiovascular events in high-risk patients, although evidence remains sparse. Therefore, we aim to determine whether a single-shot postoperative SGB can reduce the incidence of myocardial injury after non-cardiac surgery (MINS) and improve recovery in patients undergoing laparoscopic radical resection for colorectal cancer.

METHODS AND ANALYSIS

This is an investigator-initiated, single-centre, randomised, two-arm clinical trial enrolling patients aged over 45 years and scheduled for elective laparoscopic radical colorectal surgery with at least one risk factor for MINS. A total of 950 eligible patients will be randomised into a routine or block groups. The primary outcome is the incidence of MINS. The secondary outcomes include the Visual Analogue Scale of pain during rest and movement, the incidence of delirium, quality of recovery (QOR) assessed by QOR-15, and sleep quality assessed by Richards Campbell Sleep Questionnaire. Tertiary outcomes include time to first flatus, gastrointestinal complications such as anastomotic leak or ileus, length of hospital stay, collapse incidence of severe cardiovascular and cerebrovascular complications of myocardial infarction, cardiac arrest, ischaemic or haemorrhagic stroke, and all-cause mortality within 30 days after the operation.

ETHICS AND DISSEMINATION

The protocol was approved by Medical Ethics Committee of the China-Japan Union Hospital, Jilin University (Approval number: 2021081018) prior to recruitment. The study will be performed according to the guidelines of the Declaration of Helsinki. The findings of this study will be published and presented through various scientific forums.

TRIAL REGISTRATION NUMBER

ChiCTR2200055319.

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Feigin G, Velasco Figueroa S, Englesakis MF, D'Souza R, Hoydonckx Y, Bhatia A. Stellate ganglion block for non-pain indications: a scoping review. PAIN MEDICINE (MALDEN, MASS.) 2023;24:775-781. [PMID: 36727500 DOI: 10.1093/pm/pnad011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 01/26/2023] [Accepted: 01/31/2023] [Indexed: 02/03/2023]

Qu L, Liu M, Ouyang R, Li T, Long D, Jiang Y, Wang C, Cheng L. Determination of the 95% effective dose of remimazolam tosylate in anesthesia induction inhibits endotracheal intubation response in senile patients. Front Pharmacol 2023;14:1136003. [PMID: 37324498 PMCID: PMC10266225 DOI: 10.3389/fphar.2023.1136003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 05/22/2023] [Indexed: 06/17/2023] Open

Abstract

Background and Purpose: The prevalence of elderly patients prompts anesthesiologists to determine the optimal dose of medication due to the altered pharmacokinetics and pharmacodynamics of this population. The present study aimed to determine the 95% effective dose (ED₉₅) of remimazolam tosylate in anesthesia induction to inhibit endotracheal intubation-related cardiovascular reaction in frail and non-frail senile patients. Methods: A prospective sequential allocation dose-finding study of remimazolam tosylate was conducted on 80 elderly patients who received general anesthesia between May and June 2022 at the First Affiliated Hospital of Nanchang University. The initial dose was 0.3 mg/kg. The blood pressure and heart rate fluctuations during intubation were either <20% (negative cardiovascular response) or ≥20% (positive cardiovascular response). If positive, the dose of the next patient was increased by 0.02 mg/kg, while if negative, it was reduced by 0.02 mg/kg according to the 95:5 biased coin design (BCD). The ED₉₅ and 95% confidence intervals (CIs) were determined using R-Foundation isotonic regression and bootstrapping methods. Results: The ED₉₅ of remimazolam tosylate to inhibit the response during tracheal intubation was 0.297 mg/kg (95% CI: 0.231-0.451 mg/kg) and 0.331 mg/kg (95% CI: 0.272-0.472 mg/kg) in frail and non-frail senile patients, respectively. Conculation and Implications: The CI of the two groups overlap, and no difference was detected in the ED₉₅ of remimazolam tosylate in inhibiting endotracheal intubation-related cardiovascular response in frail and non-frail senile patients. These results suggested that remimazolam tosylate is an optimal anesthesia inducer for all elderly patients. Clinical Trial Registration: https://www.chictr.org.cn, identifier ChiCTR2200055709.

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Chen C, Wen D, Wang Y, Li H, Yu Q, Li M. A spray-as-you-go airway topical anesthesia attenuates cardiovascular responses for double-lumen tube tracheal intubation. BMC Anesthesiol 2022;22:203. [PMID: 35780106 PMCID: PMC9250180 DOI: 10.1186/s12871-022-01749-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 06/21/2022] [Indexed: 11/10/2022] Open

Abstract

BACKGROUND

Spray-as-you-go (SAYGo) airway topical anesthesia and nerve block are common techniques used during awake tracheal intubation. However, their effects have not been described during double-lumen tube intubation. We report on a prospective randomized study that aimed to compare the intubation effects of SAYGo and nerve block patients undergoing thoracic surgery.

METHODS

Sixty-six American Society of Anesthesiologists (ASA) physical status I and II patients were scheduled to undergo double-lumen tube (DLT) tracheal intubation for thoracic surgery. The patients were randomly assigned into control (Group C), ultrasound (Group U), and flexible intubation scope (Group F) groups with 22 cases in each group. Patients in Group C were induced with a standard anesthetic regimen. Patients in Groups U and F were treated with superior laryngeal nerve (SLN) block combined with transtracheal injection (TTI) and given a SAYGo airway topical anesthesia before intubation. Hemodynamic variables during intubation process were recorded as the primary outcome. Additional patient data were recorded including the occurrence of adverse events, the level of hoarseness, the occurrence of sore throats, memory function and the level of patient satisfaction with anesthesia.

RESULTS

The blood pressure (BP) and heart rate (HR) of patients in group C was significantly increased 1 min after tracheal intubation (P < 0.05) compared to before anesthesia. The BP and HR of patients in Groups U and F remained stable. 10 cases of hypertension were observed in Group C, 6 cases in Group U and 1 case in Group F. In Group C, tachycardia was observed in 9 patients along with 9 cases in Group U and 4 cases in Group F. In Group U, 4 patients experienced puncture and bleeding were and 8 patients had a poor memory of TTI. No significant differences were found in the incidence of hoarseness, sore throats, and satisfaction with anesthesia in postoperative follow-up.

CONCLUSIONS

SAYGo airway topical anesthesia and SLN block combined with the TTI technique can inhibit the cardiovascular response during DLT tracheal intubation. The SAYGo technique has fewer complications and more advantages compared to other approaches.

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Liu J, Ma W, Huang Y, Liu H, Wu C. Prediction, prevention and management of new onset peri-operative atrial fibrillation and flutter in patients undergoing non-cardiac thoracic surgery: a narrative review. Minerva Anestesiol 2022;88:490-498. [PMID: 35475332 DOI: 10.23736/s0375-9393.21.16034-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]

Lv L, Yan L, Liu X, Chen M. Effectiveness of lidocaine/prilocaine cream on cardiovascular reactions from endotracheal intubation and cough events during recovery period of older patients under general anesthesia: prospective, randomized placebo-controlled study. BMC Geriatr 2020;20:157. [PMID: 32366224 PMCID: PMC7197116 DOI: 10.1186/s12877-020-01567-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 04/22/2020] [Indexed: 11/10/2022] Open

Impact of thoracic paravertebral block combined with general anesthesia on postoperative cognitive function and serum adiponectin levels in elderly patients undergoing lobectomy. Wideochir Inne Tech Maloinwazyjne 2019;14:538-544. [PMID: 31908700 PMCID: PMC6939210 DOI: 10.5114/wiitm.2019.84742] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 03/02/2019] [Indexed: 11/25/2022] Open

Colak F, Ozgul U, Erdogan MA, Kayhan GE, Erdil FA, Çolak C, Durmus M. Comparison of hemodynamic responses and QTc intervals to tracheal intubation with the McGRATH MAC videolaryngoscope and the Macintosh direct laryngoscope in elderly patients. Kaohsiung J Med Sci 2019;35:116-122. [PMID: 30848023 DOI: 10.1002/kjm2.12017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 11/22/2018] [Indexed: 11/09/2022] Open

Pu S, Chen J, Gu X, Xu Y, Wu J, Lv Y, Du D. Effects of ultrasound-guided stellate ganglion block on cervical vascular blood flow: study protocol for a randomized controlled trial. Trials 2018;19:426. [PMID: 30086776 PMCID: PMC6081863 DOI: 10.1186/s13063-018-2736-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2017] [Accepted: 06/08/2018] [Indexed: 01/03/2023] Open

Kim YU, Shin YJ, Cho YW. Use of stellate ganglion block for treatment of recurrent syncope followed by chest pain. Yeungnam Univ J Med 2018;35:104-108. [PMID: 31620579 PMCID: PMC6784663 DOI: 10.12701/yujm.2018.35.1.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 09/22/2017] [Accepted: 09/28/2017] [Indexed: 11/04/2022] Open

Liao CD, Rau CL, Liou TH, Tsauo JY, Lin LF. Effects of Linearly Polarized Near-Infrared Irradiation Near the Stellate Ganglion Region on Pain and Heart Rate Variability in Patients with Neuropathic Pain. PAIN MEDICINE 2017;18:488-503. [PMID: 27452896 DOI: 10.1093/pm/pnw145] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]

Ding XD, Ding ZG, Wang W, Liu YP, Zhong J, Chen HX. Ultrasound guided injections of botulinum toxin type A into stellate ganglion to treat insomnia. Exp Ther Med 2017;14:1136-1140. [PMID: 28810569 PMCID: PMC5525588 DOI: 10.3892/etm.2017.4612] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Accepted: 06/02/2017] [Indexed: 11/07/2022] Open

Song IK, Ji S, Kim EH, Lee JH, Kim JT, Kim HS. Heart rate variability may be more useful than pulse transit time for confirming successful caudal block under general anesthesia in children. Anesth Pain Med (Seoul) 2017. [DOI: 10.17085/apm.2017.12.2.140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open

Cheng LJ, Li GP, Li J, Chen Y, Wang XH. Effects of Fluvastatin on Characteristics of Stellate Ganglion Neurons in a Rabbit Model of Myocardial Ischemia. Chin Med J (Engl) 2017;129:549-56. [PMID: 26904989 PMCID: PMC4804436 DOI: 10.4103/0366-6999.176991] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open

Abstract

BACKGROUND

Stellate ganglion (SG) plays an important role in cardiovascular diseases. The electrical activity of SG neurons is involved in the regulation of the autonomic nervous system. The aim of this research was to evaluate the effects of fluvastatin on the electrophysiological characteristics of SG neurons in a rabbit model of myocardial ischemia (MI).

METHODS

The MI model was induced by abdominal subcutaneous injections of isoproterenol in rabbits. Using whole-cell patch clamp technique, we studied the characteristic changes of ion channels and action potentials (APs) in isolated SG neurons in control group (n = 20), MI group (n = 20) and fluvastatin pretreated group (fluvastatin group, n = 20), respectively. The protein expression of sodium channel in SG was determined by immunohistochemical analysis.

RESULTS

MI and the intervention of fluvastatin did not have significantly influence on the characteristics of delayed rectifier potassium channel currents. The maximal peak current density of sodium channel currents in SG neurons along with the characteristics of activation curves, inactivation curves, and recovery curves after inactivation were changed in the MI group. The peak current densities of control group, MI group, and fluvastatin group (n = 10 in each group) were -71.77 ± 23.22 pA/pF, -126.75 ± 18.90 pA/pF, and -86.42 ± 28.30 pA/pF, respectively (F = 4.862, P = 0.008). Fluvastatin can decrease the current amplitude which has been increased by MI. Moreover, fluvastatin induced the inactivation curves and post-inactive recovery curves moving to the position of the control group. But the expression of sodium channel-associated protein (Nav1.7) had no significantly statistical difference among the three groups. The percentages of Nav1.7 protein in control group, MI group, and fluvastatin group (n = 5 in each group) were 21.49 ± 7.33%, 28.53 ± 8.26%, and 21.64 ± 2.78%, respectively (F = 1.495, P = 0.275). Moreover, MI reduced the electrical activity of AP and increased amplitude of AP, fluvastatin pretreatment could recover amplitude and electrical activity of AP. The probability of neurons induced continuous APs were 44.44%, 14.29%, and 28.57% in control group, MI group, and fluvastatin group, respectively.

CONCLUSIONS

Fluvastatin pretreatment can recover electrophysiology characteristics of ion channel and AP in SG neurons in a rabbit model of MI. It could be considered as potential method for treating coronary heart diseases.

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Zhao HY, Yang GT, Sun NN, Kong Y, Liu YF. Efficacy and safety of stellate ganglion block in chronic ulcerative colitis. World J Gastroenterol 2017;23:533-539. [PMID: 28210090 PMCID: PMC5291859 DOI: 10.3748/wjg.v23.i3.533] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 10/18/2016] [Accepted: 11/16/2016] [Indexed: 02/06/2023] Open

Abstract

AIM

To investigate the efficacy and safety of stellate ganglion block for the treatment of patients with chronic ulcerative colitis.

METHODS

A total of 120 randomly selected patients with chronic ulcerative colitis treated in Cangzhou Central Hospital from January 2014 to January 2016 were included in this study. These patients were divided into two groups: control group (n = 30), patients received oral sulfasalazine treatment; experimental group (n = 90), patients received stellate ganglion block treatment. Clinical symptoms and disease activity in these two groups were compared before and after treatment using endoscopy. Blood was collected from patients on day 0, 10, 20 and 30 after treatment. Enzyme-linked immunosorbent assay was performed to determine interleukin-8 (IL-8) level. The changes in IL-8 level post-treatment in the two groups were compared using repeated measures analysis of variance.

RESULTS

After treatment, clinical symptoms and disease activity were shown to be alleviated by endoscopy in both the control and experimental groups. However, patients in the control group did not have obvious abdominal pain relief. In addition, the degree of pain relief in the experimental group was statistically better than that in the control group (P < 0.05). Ten days after treatment, IL-8 level was found to be significantly lower in the experimental group than in the control group, and the difference was statistically significant (P < 0.05). In addition, adverse events were significantly higher in the control group than in the experimental group, and the difference was statistically significant (χ² = 33.215, P = 0.000).

CONCLUSION

The application of stellate ganglion block effectively improves treatment efficacy in chronic ulcerative colitis, relieves clinical symptoms in patients, and reduces the level of inflammatory factors. Furthermore, this approach also had a positive impact on the disease to a certain extent.

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Antioxidation Role of Different Lateral Stellate Ganglion Block in Isoproterenol-Induced Acute Myocardial Ischemia in Rats. Reg Anesth Pain Med 2017;42:588-599. [DOI: 10.1097/aap.0000000000000647] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]

Mehnert U, de Kort LM, Wöllner J, Kozomara M, van Koeveringe GA, Kessler TM. Effects of onabotulinumtoxinA on cardiac function following intradetrusor injections. Exp Neurol 2016;285:167-172. [PMID: 27342082 DOI: 10.1016/j.expneurol.2016.06.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2016] [Revised: 06/04/2016] [Accepted: 06/20/2016] [Indexed: 11/15/2022]

Abstract

OnabotulinumtoxinA intradetrusor injections are considered a highly effective localized therapy for refractory detrusor overactivity. However, despite evidence for distant systemic effects of onabotulinumtoxinA, little is known on potential systemic side effects following intradetrusor injections. Given that onabotulinumtoxinA is a highly potent toxin this is an important safety issue specifically with regard to repeat injections and parallel treatments with botulinum toxin. Hence, it was the purpose of this prospective study to investigate, using heart rate variability (HRV) analysis, whether onabotulinumtoxinA causes systemic effects on cardiac function following intradetrusor injections. Patients with neurogenic detrusor overactivity (NDO) and age-matched healthy controls were recruited. Concomitant medication and diseases affecting the cardio-vascular system were exclusion criteria. A 3-channel resting electrocardiogram (ECG) was recorded in supine position for 15min during four consecutive visits: 1) 2weeks prior onabotulinumtoxinA intradetrusor injections, 2) 10min prior injections, 3) 30min after injections, and 4) 6weeks after injections. NDO patients received intradetrusor injections (300units Botox®) between visits 2 and 3. The control group had no intervention. Short-term (5min) HRV analysis included assessment of frequency and time domain parameters. Statistical analysis was performed using ANOVA with repeated measures and the t-test. Due to multiple comparisons, α was corrected to 0.0125 (Bonferroni method). Twelve healthy volunteers (5♀, 7♂; 46±12years old) and 12 NDO patients (5♀, 7♂; 46±13years old) completed all measurements. Comparing both groups, resting heart rate was significantly higher in the patients group at visit 4 only. No further significant differences in time and frequency domain parameters were discovered. Within the NDO group, standard deviation of the normal to normal intervals (SDNN) in the ECG demonstrated a significant decrease (1.70 to 1.53ms, p=0.003) from visit 3 to 4, whereas the total power (TP) significantly increased (3.05 to 3.29ms², p=0.009) from visit 2 to 3. This increase subsided until visit 4.

STUDY LIMITATIONS

single treatment investigation under resting conditions only. In conclusion, onabotulinumtoxinA intradetrusor injections do not seem to affect resting state cardiac function. Short-term changes such as total power might rather result from natural cardio-vascular responses to the procedure itself (e.g. discomfort, stress). Further detailed investigations also under physical stress and repeated injections are necessary to fully exclude systemic cardiac side effects of onabotulinumtoxinA intradetrusor injections.

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Leftheriotis D, Flevari P, Kossyvakis C, Katsaras D, Batistaki C, Arvaniti C, Giannopoulos G, Deftereos S, Kostopanagiotou G, Lekakis J. Acute effects of unilateral temporary stellate ganglion block on human atrial electrophysiological properties and atrial fibrillation inducibility. Heart Rhythm 2016;13:2111-2117. [PMID: 27353237 DOI: 10.1016/j.hrthm.2016.06.025] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Indexed: 01/04/2023]