Effects of ultrasound-guided stellate ganglion block on autonomic nervous function during CO2-pneumoperitoneum

Chen, Yong Q.; Xie, Yuyizi; Xue, Yurong; Wang, Bin; Jin, Xiaoju

doi:10.1016/j.jclinane.2016.03.019

Cited by 16 publications

(9 citation statements)

References 19 publications

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“…Surgery, pain, gut damage, CO 2 used to establish pneumoperitoneum, and other factors directly or indirectly activate the sympathetic nerves and inhibit postoperative gastrointestinal function recovery. Activated sympathetic nerves increase the release of catecholamines, which inhibit postoperative gastrointestinal function by restricting intestinal smooth muscle contraction[ 16 , 17 ]. DEX is a highly selective α2-adrenoceptor agonist that acts on α2-adrenoceptors in the central nervous system to reduce the upregulation of sympathetic nerve activation and decrease catecholamine release[ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Impact of intravenous dexmedetomidine on postoperative bowel movement recovery after laparoscopic nephrectomy: A consort-prospective, randomized, controlled trial

Huang¹,

Song²,

Yang³

et al. 2021

WJCC

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BACKGROUND Postoperative ileus is a frequent postoperative complication, especially after abdominal surgery. Sympathetic excitation is the primary factor for postoperative ileus. Sympathetic activation becomes increased by surgical stress, postoperative pain, and inflammation. Dexmedetomidine (DEX) can inhibit sympathetic nerve activity, inflammation, and pain. AIM To observe whether DEX promotes bowel movements in patients after laparoscopic nephrectomy. METHODS One hundred and twenty patients undergoing laparoscopic nephrectomy were assigned to three groups: C (normal saline infusion), D1 (DEX 0.02 µg/kg/h), and D2 (DEX 0.04 µg/kg/h). The primary outcomes were the recorded times to first flatus, defecation, and eating after surgery. The secondary outcomes were postoperative pain, assessed using the numerical rating scale (NRS), adverse effects, and the duration of the postoperative hospital stay. RESULTS The times to first flatus, defecation, and eating in groups D1 and D2 were significantly shorter than those in group C ( P < 0.01). The NRS scores at 8 h and 24 h after surgery were significantly lower in groups D1 and D2 than in group C ( P < 0.05). No adverse effects were observed ( P > 0.05). CONCLUSION Postoperative infusion of DEX at 0.04 µg/kg/h facilitates bowel movements in patients undergoing laparoscopic nephrectomy.

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Section: Discussionmentioning

confidence: 99%

Impact of intravenous dexmedetomidine on postoperative bowel movement recovery after laparoscopic nephrectomy: A consort-prospective, randomized, controlled trial

Huang¹,

Song²,

Yang³

et al. 2021

WJCC

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“…Laparoscopic surgery can reduce surgical trauma and weaken the immune response compared with open surgery, reducing the time for atulence and shorting the time to resume a soft diet after surgery and decreasing the length of the hospital stay [12 ~ 14]. Visualizing laparoscopic surgery and pneumoperitoneum induction can lead to sympathetic nerve activation [15,16]. In addition, CO 2 pneumoperitoneum can induce hypercarbia, which can directly or indirectly stimulate the sympathetic nervous system and cause evaluated levels of catecholamine [15,17].…”

Section: Discussionmentioning

confidence: 99%

“…Visualizing laparoscopic surgery and pneumoperitoneum induction can lead to sympathetic nerve activation [15,16]. In addition, CO 2 pneumoperitoneum can induce hypercarbia, which can directly or indirectly stimulate the sympathetic nervous system and cause evaluated levels of catecholamine [15,17]. Sympathetic stimulation could provide the main inhibitory force for intestinal peristalsis, while parasympathetic stimulation enhances gastrointestinal motility [18].…”

Section: Discussionmentioning

confidence: 99%

Impact of Intravenous Dexmedetomidine on Postoperative Bowel Movement Recovery After Laparoscopic Nephrectomy: A Consort-Prospective, Randomized, Controlled Trial

Huang

Song

Zhou

et al. 2021

Preprint

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Background Postoperative ileus is a frequent complication after surgery, especially abdominal surgery. Of the factors, sympathetic excitation is the primary factor for postoperative ileus. Sympathetic activation is always increased by the stress of surgery and postoperative pain. It was reported that dexmedetomidine (DEX) lessens pain and inhibits the sympathetic nerve by acting on the locus coeruleus. Therefore we designed our study to observe whether DEX promotes bowel movements in patients after laparoscopic nephrectomy.MethodsOne hundred and twenty patients undergoing laparoscopic nephrectomy were assigned into three groups, group C (normal saline infusion), group D1 (DEX 0.02 µg/kg/h), and group D2 (DEX 0.04 µg/kg/h). The primary outcome was to record the times of first flatus, defecation and eating after surgery. The secondary outcome was postoperative pain accessd by the numerical rating scale (NRS), concerning adverse effects, as well as the duration of the postoperative hospital stay.ResultsThe times of first flatus, defecation and eating in groups D1 and D2 were shorter than those in group C (P<0.01). The NRS scores at 8 h and 24 h after surgery were obviously lower in groups D1 and D2 than in group C (P<0.05). There were no concerning adverse effects (P>0.05).ConclusionDEX in 0.04 µg/kg/h postoperative infusion facilitates bowel movements in patients undergoing laparoscopic nephrectomy.Trial registrationThis trial was registered in a Chinese Clinical Trial Registry (ChiCTR) center on December 23, 2015. The registered number was ChiCTR-IPR-15007628.

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“…Hypercarbia and acidosis decrease the cardiac contractility, make myocardium more sensitive to catecholamines and cause peripheral vasodilatation. But with the sympathetic activation caused by hypercarbia it finally leads to tachycardia and vasoconstriction [8] . During laparoscopic or robotic operations in urology both transperitoneal (TP) and extraperitoneal (EP) techniques are used.…”

Section: Effects Of Carbon Dioxide Absorptionmentioning

confidence: 99%

“…Vagal stimulation may cause bradyarrhythmia (in a range from bradycardia to asystole) and hypotension [7,20] . Tachyarrhythmia may also be experienced as a result of sympathetic activation caused by hypercarbia [8] . The effects of pneumoperitoneum and Trendelenburg position on hemodynamics are usually well tolerated in patients with normal cardiac function, but it has been reported that even in elderly patients with ASA 2-3 risk or even in patients with underlying heart conditions such as aortic stenosis, laparoscopic operations may still be safely performed with adequate monitoring and being aware of possible complications [21,22] .…”

Section: Effects On Cardiovascular Systemmentioning

confidence: 99%

Complications of robotic and laparoscopic urologic surgery relevant to anesthesia

Arslan¹,

Özgök²

2018

MIS

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How to cite this article: Arslan ME, Özgök A. Complications of robotic and laparoscopic urologic surgery relevant to anesthesia. AbstractTechnology keeps advancing in this era allowing surgery to become less invasive in many surgical sciences. Besides these technological advances, minimally invasive procedures such as laparoscopy and robotic assisted laparoscopy are preferred widely around the globe by both surgeons and patients. Because of the increasing demand to laparoscopy and robotic surgery, anesthetists also should adapt to these specific surgical procedures. Carbon dioxide (CO 2 ) insufflation is applied in these procedures in order to provide working space and exposure to target organs. CO 2 insufflation (pneumoperitoneum if applied intrabdominally) and positional maneuvers such as steep Trendelenburg position is used in urologic laparoscopy and robotic surgery, which have vital effects on patient's physiology regarding cardiovascular, respiratory, renal, ocular and neurological systems. Special positions and unique surgical tools used in these procedures may hinder vital interventions such as cardiopulmonary resuscitation and open conversion. Comprehension of these pathophysiological effects and specific considerations is crucial to detect, to prevent and to manage serious complications that may occur during surgery.

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Effects of ultrasound-guided stellate ganglion block on autonomic nervous function during CO2-pneumoperitoneum

Cited by 16 publications

References 19 publications

Impact of intravenous dexmedetomidine on postoperative bowel movement recovery after laparoscopic nephrectomy: A consort-prospective, randomized, controlled trial

Impact of intravenous dexmedetomidine on postoperative bowel movement recovery after laparoscopic nephrectomy: A consort-prospective, randomized, controlled trial

Impact of Intravenous Dexmedetomidine on Postoperative Bowel Movement Recovery After Laparoscopic Nephrectomy: A Consort-Prospective, Randomized, Controlled Trial

Complications of robotic and laparoscopic urologic surgery relevant to anesthesia

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