Myocardial Protection Of Stellate Ganglion Block In Elderly Diabetic Patients Undergoing Laparosopic Radical Resection Of Colorectal Cancer

Objective:To explore the myocardial protection effect of general anesthesia combined with stellate ganglion block on elderly diabetics undergoing radical resection of colorectal cancer.Methods:A total of 80 diabetics undergoing laparoscopic radical resection of colorectal cancer were selected,whose BMI were 18.5～23.9kg/m²,age were 65～80 and ASA wereⅡorⅢ.The patients were randomly separated into 2 groups（n=40）.General anesthesia combined with SGB group（S）and general anesthesia group（C）.Patients in group S were given 0.2%roguacaine 4ml for RSGB 30minutes before anesthesia induction,patients in group C were underwent general anesthesia,and both groups were given intravenous anesthesia during the perianesthetic period.The HR,SBP and DBP were recorded at the time of entry（T₀）,immediately after endotracheal intubation（T₁）,immediately after peeling（T₂）,30min after pneumoperitoneum establishment（T₃）,and immediately after operation（T₄）,and the product of SBP and HR was calculated as myocardial oxygen consumption（heart rate-blood pressureproduct,RPP）.2ml venous blood were drawn from patients at T₀,T₂,T₄ and T₅ time points to determine serum Glucose（Glu）and Cortisol（Cor）concentrations.Serum concentrations of Troponin I-UItro（Tn I-UItro）and N-terminal B-type natriuretic peptide（NT-pro BNP）were determined at T₀ and T₅.Cardiovascular adverse events were recorded during the operation and duration of hospital.Results:1.There were no significant differences in gender,age,BMI,ASA,type of surgery,Hb A1c and operation duration between the two groups（P>0.05）.2.Compared with T₀,SBP,DBP,HR and RPP increased significantly at T₁ and T₂.Compared with group C,SBP,DBP,HR and RPP in group S were significantly decreased at T₁ and T₂,with statistical significance（P<0.05）.3.Compared with T₀,the concentrations of Glu and Cor were significantly increased at T₂,T₄ and T₅,and the differences were statistically significant（P<0.05）.Compared with group C,Glu and Cor concentration in group S were significantly decreased at T₂,T₄ and T₅,and the differences were statistically significant（P<0.05）.4.Compared with T₀,the concentrations of Tn I-UItro and NT-pro BNP in the two groups were significantly increased at T₅,and the differences were statistically significant（P<0.05）;At T₅,compared with group C,the concentrations of Tn I-UItro and NT-pro BNP in group S were significantly reduced,and the differences were statistically significant（P<0.05）.5.Cardiovascular adverse events:There were 3 cases of hypertension,1 case of bradycardia,1 case of hypotension,1 case of tachycardia,1 case of atrial premature beat and 1 case of myocardial ischemia in group S,a total of 8 cases,the total incidence is 21.62%.there were 7 cases of hypertension,2 cases of bradycardia,3 cases of hypotension,3 cases of tachycardia,1 case of ventricular premature beat,2 cases of atrial premature beat,2 cases of myocardial ischemia in group C,a total of 20 cases,with a total incidence of 55.56%.The total incidences of cardiovascular adverse events in group S were lower than that in group C,and the differences were statistically significant（P<0.05）.Conclusions:General anesthesia combined with stellate ganglion block can alleviate perioperative hemodynamic fluctuations,reduce myocardial oxygen consumption,reduce perioperative stress response,maintain relatively stable blood glucose,and reduce the occurrence of cardiovascular adverse events in elderly diabetic patients undergoing laparoscopic radical resection of colorectal cancer,thus playing a certain role in myocardial protection.