Ultrasound-guided Stellate Ganglion Block Improves Gastrointestinal Function After Thoracolumbar Spinal Surgery

Peng, Ke; Zhang, Juan; Chen, Weirong; Liu, Hua-yue; Ji, Fuhai

doi:10.1016/j.clinthera.2017.09.008

Cited by 15 publications

(20 citation statements)

References 33 publications

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“…Although the ISS scores were lower in mice with spinal fracture (group f, ISS = 9), the severe gastrointestinal dysfunction in this group can be explained by the fact that spinal injury causes peritoneal hematoma, which in turn strongly affects gastrointestinal function. 22,23 Deficits in the Model Although the experimental results demonstrated the validity of the animal model created in this study, the characteristics of the experimental animals themselves, as well as those of the injuries, must be taken into account. First, humans walk upright, while mice move using four legs.…”

Section: Gastrointestinal Dysfunction Modelingmentioning

confidence: 90%

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An Innovative Model of ISS‐Based Multiple Fractures and Gastrointestinal Dysfunction Related to c‐Kit Protein Expression on Interstitial Cells of Cajal

Meng

Fan

Qian

et al. 2023

Orthopaedic Surgery

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Objective Gastrointestinal dysfunction seriously affects the prognosis and quality of life of patients with multiple fractures. However, experimental evidence of this relationship is lacking. Here we describe a newly developed mouse model of postoperative gastrointestinal dysfunction after multiple fractures. Methods Trauma severity was assessed using the injury severity score (ISS). Based on the ISS, a multiple fracture model was established in mice as follows: limb fractures with pelvic fractures and multiple rib fractures; limb fractures with multiple rib fractures; closed fracture of both forelegs with pelvic fracture and rib fractures; closed limb fractures; limb fracture with pelvic fracture; spinal fractures; hind leg fractures with pelvic fractures; pelvic fracture with multiple rib fractures; closed fracture of both fore legs with pelvic fracture; and closed fracture of both fore legs with multiple rib fractures. In each model group, gastrointestinal motility was assayed and the histopathology of the small intestine was examined. Western blot and immunohistochemical analyses of jejunal tissue were performed to detect c‐kit protein expression, the level of which was compared with that of a control group. The results of ANOVA are expressed as mean ± standard deviation. Results In mice with multiple fractures, food intake was greatly reduced, consistent with histopathological evidence of an injured intestinal epithelium. The jejunal tissue of mice in groups a, c, f, and h was characterized by extensively necrotic and exfoliated intestinal mucosal epithelium and inflammatory cell infiltration in the lamina propria. In the gastrointestinal function assay, gastrointestinal motility was significantly reduced in groups a, b, c, f, and g; these group also had a higher ISS ( p < 0.01). The expression of c‐kit protein in groups with gastrointestinal dysfunction was significantly up‐regulated ( p < 0.001) compared with the control group. The close correlation between c‐kit expression and the ISS indicated an influence of trauma severity on gastrointestinal motility. Conclusion Gastrointestinal dysfunction after multiple fractures was successfully reproduced in a mouse model. In these mice, c‐kit expression correlated with gastrointestinal tissue dysfunction and might serve as a therapeutic target.

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Section: Gastrointestinal Dysfunction Modelingmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

An Innovative Model of ISS‐Based Multiple Fractures and Gastrointestinal Dysfunction Related to c‐Kit Protein Expression on Interstitial Cells of Cajal

Meng

Fan

Qian

et al. 2023

Orthopaedic Surgery

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“…The postoperative period is associated with the disturbance of gastrointestinal function, such as bowel irritation and abdominal bloating. These problems occur mainly due to the imbalance between the sympathetic nervous system and the vagal nerve system attributed to operation stress, immobilization, and perioperative administration of opioids and narcotics [ 12 ]. Gastrointestinal morbidity can cause delayed feeding, anxiety, and sleep disturbance, leading to impaired patient recovery, prolonged hospital stay, and higher healthcare costs [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

“…SGB, a well-established anesthesia technique, is commonly used to treat sympathetically related pain in the upper limbs, head, and neck. Besides, ultrasound-guided SGB preceding general anesthesia enhanced the recovery of gastrointestinal functions in patients with laparoscopic colorectal cancer surgery [ 11 ] and thoracolumbar spinal surgery [ 12 ]. Furthermore, SGB could also relieve postoperative pain and decrease intraoperative requirements for anesthetics and analgesics in patients with complex regional pain syndrome [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Effects of Ultrasound-Guided Stellate Ganglion Block on Postoperative Quality of Recovery in Patients Undergoing Breast Cancer Surgery: A Randomized Controlled Clinical Trial

Yang

Wang

et al. 2022

Journal of Healthcare Engineering

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Surgery has been the primary treatment for breast cancer. However, instant postoperative complications, such as sleep disorder and pain, dramatically impair early postoperative quality of recovery, resulting in more extended hospital stays and higher costs. Recent clinical trials indicated that stellate ganglion block (SGB) could prolong sleep time and improve sleep quality in breast cancer survivors. Moreover, during the perioperative period, SGB enhanced the recovery of gastrointestinal functions in patients with laparoscopic colorectal cancer surgery and thoracolumbar spinal surgery. Furthermore, perioperative SGB decreased intraoperative requirements for anesthetics and analgesics in patients with complex regional pain syndrome. However, information is scarce regarding the effects of SGB on postoperative quality recovery in patients with breast cancer surgery. Therefore, we investigated the effects of SGB on the postoperative quality of recovery of patients undergoing breast cancer surgery. Sixty patients who underwent an elective unilateral modified radical mastectomy were randomized into two 30-patient groups that received either an ultrasound-guided right-sided SGB with 6 ml 0.25% ropivacaine (SGB group) or no block (control group). The primary outcome was the quality of postoperative recovery 24 hours after surgery, assessed with a Chinese version of the 40-item Quality of Recovery (QoR-40) questionnaire. Secondary outcomes were intraoperative requirements of propofol and opioids, rest pain at two, four, eight, and 24 hours after surgery, patient satisfaction score, and the incidence of postoperative abdominal distension. At 24 hours after surgery, global QoR-40 scores were higher in the SGB group than in the control group. Besides, in the SGB group, patients needed less propofol, had a lower incidence of postoperative abdominal bloating, and had higher satisfaction scores. Ultrasound-guided SGB could improve the quality of postoperative recovery in patients undergoing breast cancer surgery by less intraoperatively need for propofol and better postoperative recovery of sleep and gastrointestinal function.

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“…Abdominal bloating will be categorized as mild (no interruption on oral intake or sleep), moderate (delayed oral intake or use of laxatives), or severe (need for gastrointestinal decompression). 31 The definitions of postoperative complications are shown in Supplementary File 1.…”

Section: Data Collectionmentioning

confidence: 99%

Deep Neuromuscular Blockade Combined with Low Pneumoperitoneum Pressure for Nociceptive Recovery After Major Laparoscopic Gastrointestinal Surgery: Study Protocol for a Randomized Controlled Trial

Long¹,

Shan²,

Feng³

et al. 2021

JPR

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Ultrasound-guided Stellate Ganglion Block Improves Gastrointestinal Function After Thoracolumbar Spinal Surgery

Cited by 15 publications

References 33 publications

An Innovative Model of ISS‐Based Multiple Fractures and Gastrointestinal Dysfunction Related to c‐Kit Protein Expression on Interstitial Cells of Cajal

An Innovative Model of ISS‐Based Multiple Fractures and Gastrointestinal Dysfunction Related to c‐Kit Protein Expression on Interstitial Cells of Cajal

Effects of Ultrasound-Guided Stellate Ganglion Block on Postoperative Quality of Recovery in Patients Undergoing Breast Cancer Surgery: A Randomized Controlled Clinical Trial

Deep Neuromuscular Blockade Combined with Low Pneumoperitoneum Pressure for Nociceptive Recovery After Major Laparoscopic Gastrointestinal Surgery: Study Protocol for a Randomized Controlled Trial

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