Effects of ultrasound guided ganglion stellate blockade on intraoperative and postoperative hemodynamic responses in laparoscopic gynecologic surgery.

Abstract

Introduction: Laparoscopic gynecologic surgery is one of the most well-known procedures. Pneumoperitoneum with carbon dioxide insufflation can cause unfavorable hemodynamic effects due to catecholamine and vasopressin release. Aim: To examine the effects of stellate ganglion block on hemodynamic response and postoperative pain. Material and methods: In a prospective double blinded randomized parallel study we included 40 patients with ASA physical status I and II, aged between 18 and 50 years with a gynecologic problem candidate for laparoscopic surgery under general anesthesia. The patients were randomly divided into two groups. Fifteen minutes before anesthesia induction, the patients underwent ultrasound guided stellate ganglion block with 10 ml of lidocaine 1% and the control group underwent stellate ganglion block using 10 ml of distilled water as placebo. After induction of general anesthesia, systolic and diastolic blood pressure and heart rate were recorded, especially after blowing of CO 2 gas, the position change, depletion of CO 2 , and tracheal extubation in recovery. The postoperative pain was calculated using the visual analogue scale (VAS) at three times (0, 30, and 24 h after surgery). Results: Our results showed that mean systolic and diastolic blood pressure and heart rate did not show any significant difference at the measurement times (p > 0.05), and mean VAS of patients in the two groups was significantly different for the three measurement times except 24 h after surgery (p < 0.05). Conclusions: Stellate ganglion block before laparoscopic gynecologic surgery has no significant effect on intraoperative and postoperative hemodynamic responses; however, it can decrease VAS in the early postoperative period.

Regulation of acute reflectory hyperinflammation in viral and other diseases by means of stellate ganglion block. A conceptual view with a focus on Covid-19

“…It seems most successful in the early stages, as we could show ( Schaible and Straub, 2014 ; Strong et al, 2018 ). Other studies have also shown a time-dependent effect of SGB ( Rahimzadeh et al, 2020 ).…”

“…There are further examples: In a prospective, double blinded randomized parallel study SGB applied before laparoscopic gynecologic surgery decreased pain significantly immediately after surgery ( Rahimzadeh et al, 2020 ). Postoperative pain always has an inflammatory component.…”

Efficacy of ultrasound-guided stellate ganglion block in relieving acute postoperative pain: a systematic review and meta-analysis

“…The trials included in the present study were published between the years 2004 and 2022, and their sample sizes ranged from 30 to 90. The trials investigated the effects of SGB in patients who underwent various kinds of surgeries: breast surgeries in three studies, 15 – 17 abdominal surgeries in two studies, 13 , 14 and upper limb and thoracoscopic surgeries in the remaining studies. 11 , 12 Five studies compared SGB with placebo, 11 , 13 , 14 , 17 , 18 and two studies compared SGB with multimodal systemic analgesia or PCA.…”

Mesenchymal Stromal Cells Shown Effective for the Treatment of Osteoarthritis

“…SGBs may be more effective if administered as soon as possible after the onset of symptoms, as suggested by several studies for anosmia and dysgeusia not related to COVID-19. 14,[32][33][34] Although the research cited and reported in this review indicated successful SGB treatment as far as 6 months after symptom onset, further research is needed to identify whether or not such a temporal limitation exists.…”