Effects of stellate ganglion block anesthesia on cognition and biomarkers in patients undergoing gastrointestinal surgery

Table 1 Hemodynamic parameters before and after anesthesia induction (mean ± SD)

Group	Case	MABP (mmHg)				Heart rate (beats/minute)
		Time 1	Time 2	Time 3	Time 4	Time 1	Time 2	Time 3	Time 4
Control	40	89.21 ± 9.12	100.56 ± 8.72a	102.18 ± 9.24a	97.60 ± 8.78a	86.27 ± 8.56	91.12 ± 9.32a	96.78 ± 8.96a	91.62 ± 9.18a
Observation	40	89.32 ± 9.16	90.18 ± 10.44	91.27 ± 8.52	90.84 ± 9.18	86.12 ± 8.78	86.72 ± 9.27	87.16 ± 9.18	86.54 ± 9.72
t value		0.054	4.826	5.490	3.366	0.077	2.117	4.743	2.403
P value		0.957	< 0.001	< 0.001	0.001	0.939	0.037	< 0.001	0.019

^aP < 0.05 compared with the pre-anesthesia induction in the same group.

Repeated-measures ANOVA showed significant inter-group, time, and interaction effects for mean arterial pressure and heart rate (P < 0.001). MABP: Mean arterial blood pressure.

Table 2 Oxidative stress indicators before and 24 hours after surgery (mean ± SD)

Group	Case	MDA (nmol/L)		NO (nmol/mL)		SOD (U/mL)
		Before induction of anesthesia	24 hours after surgery	Before induction of anesthesia	24 hours after surgery	Before induction of anesthesia	24 hours after surgery
Control	40	4.72 ± 0.42	5.78 ± 0.36a	35.56 ± 5.21	55.60 ± 7.72a	30.16 ± 4.32	23.27 ± 3.68a
Observation	40	4.78 ± 0.45	5.21 ± 0.48a	35.78 ± 5.32	43.21 ± 6.54a	30.24 ± 4.35	27.12 ± 4.21a
t value		0.616	6.008	0.187	7.745	0.083	4.355
P value		0.539	0.008	0.852	< 0.001	0.934	< 0.001

^aP < 0.05 compared with that before anesthesia induction in the same group.

MDA: Malondialdehyde; NO: Nitric oxide; SOD: Superoxide dismutase.

Table 3 Laboratory indicators before and 24 hours after surgery (mean ± SD, ng/L)

Group	Case	Aβ-42		IL-6		tau-181 protein
		Before induction of anesthesia	24 hours after surgery	Before induction of anesthesia	24 hours after surgery	Before induction of anesthesia	24 hours after surgery
Control	40	55.86 ± 6.72	65.21 ± 7.18a	7.42 ± 1.18	13.24 ± 2.16a	9.56 ± 2.16	16.27 ± 3.25a
Observation	40	56.18 ± 6.54	60.16 ± 6.86a	7.36 ± 1.21	10.32 ± 1.54a	9.52 ± 2.24	14.18 ± 2.72a
t value		0.216	3.216	0.225	6.962	0.081	3.119
P value		0.830	0.002	0.823	< 0.001	0.935	0.003

^aP < 0.05 compared with the pre-anesthesia induction in the same group.

After Bonferroni correction, the differences between interleukin-6 groups remained significant (corrected P < 0.001), while the differences between β-amyloid peptide 42 (corrected P = 0.003) and tau-181 (corrected P = 0.004) were marginally significant (corrected α = 0.01). Aβ-42: Β-amyloid peptide 42; IL-6: Interleukin-6.

Table 4 Cognitive function scores before and 24 hours after surgery (mean ± SD, score)

Group	Case	MMSE		MoCA
		Before induction of anesthesia	24 hours after surgery	Before induction of anesthesia	24 hours after surgery
Control	40	27.72 ± 0.98	23.12 ± 0.78a	26.54 ± 1.12	22.80 ± 1.12a
Observation	40	27.54 ± 0.92	24.96 ± 0.84a	26.48 ± 1.16	23.78 ± 0.96a
t value		0.847	10.152	0.235	4.202
P value		0.400	< 0.001	0.815	< 0.001

^aP < 0.05 compared to the pre-anesthesia induction in the same group.

MMSE: Mini-Mental State Examination; MoCA: Montreal Cognitive Assessment.

Table 5 Gastrointestinal function indicators before and 24 hours after surgery (mean ± SD, pg/mL)

Group	Case	Motilin		Vasoactive peptide
		Before induction of anesthesia	24 hours after surgery	Before induction of anesthesia	24 hours after surgery
Control	40	356.72 ± 70.78	221.54 ± 52.18a	10.12 ± 1.32	20.78 ± 3.56a
Observation	40	360.12 ± 72.45	272.32 ± 60.21a	10.27 ± 1.44	16.21 ± 2.80a
t value		0.212	4.031	0.486	6.382
P value		0.832	< 0.001	0.629	< 0.001

^aP < 0.05 compared with the same group before anesthesia induction.

Table 6 Safety indicators (mean ± SD)

Group	Case	First time out of bed (hour)	Time of catheter removal (day)	VAS score 24 hours after surgery (divide)
Control	40	18.15 ± 3.82	12.73 ± 2.97	4.52 ± 1.34
Observation	40	17.32 ± 3.45	11.86 ± 2.54	4.23 ± 1.12
t value		1.021	1.432	1.138
P value		0.310	0.156	0.258

VAS: Visual analog scale.