Observation On The Therapeutic Effect Of Stellate Ganglion Block In The Treatment Of Insomnia

ObjectThrough the comparative study of stellate ganglion block with low concentration of lidocaine(0.5%) and oral medicine estazolam in the treatment of insomnia,to provide new clinical evidence for the safer and more effectively clinically treatment of insomnia. Methods40 patients with short-term insomnia which diagnosised according to China adult insomnia diagnosis and treatment guidelines were randomly divided into control and treatment groups.There was no bleeding tendency and severe cardiovascular disease in the patients.The patients in the control group were treated with oral estazolam.The different dose of estazolam is 1mg,2mg,4mg daily 30 minutes before bedtime according to the weight of the patients and drug resistance and the minimum dose that the patients’ sleep at night can reach self-satisfaction level.The patients in the treatment group were treated with stellate ganglion block by 0.5% lidocaine 5ml.The treatment of both two groups were once a day and lasted 10 days. The Stellate ganglion block treatment cycle is 10 days,for the left and right sides alternately.All patients were provided with the same sleep hygiene education.All patients were gived Pittsburgh Sleep Quality Index scale(PSQI) sleep evaluation.Made a follow-up one month after the end of treatment,and retested the scale.Compared the changes of seven factor score and total score of PSQI of the two groups of patients before and after treatment.Because of the particularity of nerve block,the heart rate(HR), noninvasive blood pressure(BP), and the end of the oxygen saturation(SPO2) of patients were observed during the treatment using ECG monitor. Results1.The treatment results The sleep time of the patients in the two groups was extended after treatment,the sleep quality was improved.Via independent sample t test analysis, the sleep quality and hypnotic drug dependence, daytime dysfunction and PSQI scores in the treatment group were better than that in control group(P < 0.05), with statistical significance.2.Treatment efficacy There is no significant difference between patients age, sex, body mass, the treatment time of two patient groups.PSQI scores showed no significant difference before treatment. Efficacy evaluation:①Cured: PSQI total score of≦2, average nightly sleep time> 6h, daytime function feel good themselves.②Markedly: PSQI 3 to 5, average nightly sleep time 5 ~ 6hours, feel better daytime functioning.③Effective: PSQI 6 to 7,sleep time 4 ~ 5hours, daytime function is good.④Invalid:no change after treatment. Follow-up results showed that in the control group whose total effective rate was 70% 3 cases were cured,5 cases had marked effect,6 cases were improved,and 6 cases had no effect.In the treatment group whose total effective rate was 85% 4 cases were cured,7 cases had marked effect,6 cases were improved,and 3 case had no effect.By chi-square test,there was no significant difference in two gruops(P>0.05).In the treatment of insomnia,stellate ganglion block with 0.5% lidocaine can be made no less efficacy than oral drugs.The effectiveness of treatment group has a tendency to improve in terms of efficacy.There was no obvious significance in statistical, maybe related to the cases of this experiment samples were not enough.3.Hemodynamic parameters The patients in the treatment group were detected HR, BP, SPO2 with ECG monitor automatically before and after the treatment.The results showed that the hemodynamic parameters of the patients in the treatment group were within the normal range of fluctuation before and after treatment,and there was no significant difference.(P>0.05) Conclusion1 Stellate ganglion block with 0.5% lidocaine for the treatment of chronic insomnia had no significant different effect with oral drugs.It can effectively improve the sleep quality and daytime dysfunction of patients.2 Stellate ganglion block with 0.5% lidocaine kinetics had no effect on patient’s bloodstream.It is safe and reliable.