| Stellate ganglion block (SGB) is composed of inferior cervical ganglion and first thoracic ganglion nearby. Its postganglionic fiber is distributed over blood vessel smooth muscle and gland , for example head and cervix, face, upper limb, lungs, trachea, heart, etc. Stellate ganglion block could treat varieties of tissue and organ illness, causing adrenergic nerve overexcitating. To Increase blood flow of allocating region, to improve circulation, and to adjust central nervous system immune system endocrine system SGB is applied to treating pain in increasingly large numbersand, but it is reported to be used undergoing coronary arterie bypass grafting. This study is purposed to observe variation he-modynamics and endocrine, on course of narcosis and operation , while to exert unilateral SGB on the operation.Material and Methods24 cases of CABG patients in extracorporeal circulation (15 cases men and 9 cases women,age from 48 to 83) are equal two groups. One is SGB (S) , the other is normal control(N). Tow groups are in the methods of anesthesia and in the process of operation the same. It is presume that time - point is before anesthesia (T0) , after trachea intubation (T1) , after open -sternum (T2) , 10 minute after CPB start (T3) , 10 minute after CPB finish (T4) , meanwhile to record heart rate ( HR ) systolic blood pressure ( SBp ) mean arterial pressure (MAP) RPP. Venous blood is drown in T0 T3. Cortisol(COR) is examined in blood plasm with fluorescence immunoassay.Numeration data is expressed with x ?s. Variance test is used analyzenu-merical data.ResultTwo groups in age gender body weight cardiac functional grading CAGB quantity CPB time, is no statistical significance. Compare with control, MAP and RPP in SGB is clearly lower ( P <0.01) in T1 T2, HR is also lower ( P < 0.05). MAP and RPP is too lower in T3 T4. Compare with control, Cortisol content reduce obviously in SGB ( P <0.01).DiscussionStress is a series of nervous and endocrine reaction in sympathetic nerve excitation and hypophysis - adrenal cortex excitation because of body stimulated to all kinds of strong factor ( stressor) , and is all kinds of functional and metabolic variation. Stress strongly could be generate much nonspecific variation of patho-physiology and be disadvantage to body. It is the mass of being advanced in years and valetudinariany in patient in want of exerting coronary arterie bypass grafting(CABG). Their coronary artery disease is very serious, coronary arteries are very narrow and even occlusive, and cardiac muscle is ischemia and hy-poxia. So their cardiovascular system in endurance is insufficient. It is much dangerous to exert CABG operation in the patient s capability of the compensation and reserve illy. How to relieve their stress in CABG, anesthetist in' the clinical and scientific effort focus on riding out a storm of anesthetic intubate operation on heart CPB etc. In present CABG is dependent on deepening anesthetize to reduce undergoing reaction throughout using a great dose of Fentunyl and general anesthesia sedative hypnotic. But it is not linear relation between a dose of Fentunyl and stress reaction. Just to major Fentunyl could not inhibit from stress response. Just to major anesthesia could increase anesthesia risk. It is reported that epidural block could stabilize stress response. General anesthesia combined with TEB can efficiently holdback stress response at the open - heart surgery, but there are some disputes at CABG. The major reason is that general anesthesia combined with TEB at the CABG has the possibly complication of epi-dural haematoma. Some people consider with the heparin the incidence of epi-dural haematoma increase obviously. Both SGB and TEB belong to block nerve. There are some similarity to effect of stress response. SGB can block sympathetic nerve to head, neck, limb, heart, lung, decrease erethism of sympathetic nerve. Some people report that SGB can apparently holdback cardiovascular response of trachea intubation in the non - heart - surgery. Thi...
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