Effect Of Ultrasound-guided Stellate Ganglion Block On Hemodynamics During Periextubation Of General Anesthesia

BackgroundPatients under general anesthesia are prone to hemodynamic fluctuations during peri-extubation.In recent years,how to use reasonable methods to reduce cardiovascular reactions during extubation had become a research hotspot in anesthesiology.Ultrasound-guided C7 stellate ganglion block(SGB)can effectively block the conduction of sympathetic excitation and reduce stress response.Some studies indicate that ultrasound-guided C7 SGB can effectively reduce the cardiovascular reaction during endotracheal intubation and it is safe and effective.The effect of ultrasound-guided C7 stellate ganglion block on cardiovascular response during extubation is relatively rare.ObjectiveTo observe the effect of ultrasound-guided C7 SGB on hemodynamics during periextubation in patients with general anesthesia.MethodsSixty patients undergoing elective surgery of chest and abdomen(ASA grade I/II)were selected and then divided into groups A,B and C according to a random number table,with 20 patients per group.Preoperative intubation was rapidly induced by general anesthesia,and intraoperative mechanical ventilation was adopted during surgery.Before the patients were taken to postanesthesia care unit after the stop of anesthesia,the patients in groups A and B were separately treated with left and right ultrasound-guided C7 SGB at the end of the surgery,while no postsurgery operation was carried out in group C.When the patients met the extubation indications,endotracheal intubation was removed with sputum aspiration.The systolic blood pressure,diastolic blood pressure and heart rate were recorded before leaving the operating room(the foundation value,T0),when the tracheal tube was removed(T1)and 5 min after extubation(T2).Meanwhile,the number of cases of appearing Homer’s syndrome was recorded,and the occurrence of related complications such as hoarseness and neurovascular injury were observed in groups A and B after SGB.ResultsCompared with those in groups A and B,the systolic blood pressure and diastolic blood pressure in group C were significantly increased and heart rate was significantly accelerated at T1 and T2 as compared with T0(P<0.05).Horner’s syndrome occurred in groups A and B after SGB,but no related complication was found.ConclusionUltrasound-guided C7 SGB can effectively reduce cardiovascular response during extubation in patients undergoing elective surgery of chest and abdomen.Moreover,because of its high success rate and fewer complications,ultrasound-guided C7 SGB is considered safe and effective.