Diabetes mellitus is an independent risk factor for ischemic stroke.Both diabetes mellitus and stroke are linked to systemic inflammation that aggravates patient outcomes.Stellate ganglion block can effectively regula...Diabetes mellitus is an independent risk factor for ischemic stroke.Both diabetes mellitus and stroke are linked to systemic inflammation that aggravates patient outcomes.Stellate ganglion block can effectively regulate the inflammatory response.Therefore,it is hypothesized that stellate ganglion block could be a potential therapy for ischemic stroke in diabetic subjects.In this study,we induced diabetes mellitus in rats by feeding them a high-fat diet for 4 successive weeks.The left middle cerebral artery was occluded to establish models of ischemic stroke in diabetic rats.Subsequently,we performed left stellate ganglion block with 1%lidocaine using the percutaneous posterior approach 15 minutes before reperfusion and again 20 and 44 hours after reperfusion.Our results showed that stellate ganglion block did not decrease the blood glucose level in diabetic rats with diabetes mellitus but did reduce the cerebral infarct volume and the cerebral water content.It also improved the recovery of neurological function,increased 28-day survival rate,inhibited Toll like receptor 4/nuclear factor kappa B signaling pathway and reduced inflammatory response in the plasma of rats.However,injection of Toll like receptor 4 agonist lipopolysaccharide 5 minutes before stellate ganglion block inhibited the effect of stellate ganglion block,whereas injection of Toll like receptor 4 inhibitor TAK242 had no such effect.We also found that stellate ganglion block performed at night had no positive effect on diabetic ischemic stroke.These findings suggest that stellate ganglion block is a potential therapy for diabetic ischemic stroke and that it may be mediated through the Toll like receptor 4/nuclear factor kappa B signaling pathway.We also found that the therapeutic effect of stellate ganglion block is affected by circadian rhythm.展开更多
Objective:To investigate the protective effect of sinomenine stellate ganglion block(SGB)on chronic myocardial ischemia and its related mechanism.Methods:SD male and female rats(180~200g)were randomly divided into fou...Objective:To investigate the protective effect of sinomenine stellate ganglion block(SGB)on chronic myocardial ischemia and its related mechanism.Methods:SD male and female rats(180~200g)were randomly divided into four groups:blank group,model group,lidocaine group,lidocaine+sinomenine group.The rats in blank group were fed with normal standard diet without modeling,and the other rats were fed with high-fat diet.After 8 weeks of feeding,the rats in high-fat diet group were significantly different from those in blank control group.Then they were randomly divided into 3 groups,10 rats in model group were injected with 0.9%NaCl into right stellate ganglion(RSG)After 2 weeks of continuous injection,pituitrin injection was continuously injected into sublingual vein of rats for 3 days,once every 24 hours;lidocaine group rats were injected with 0.24 mL 1%lidocaine injection in RSG,the rest was the same as model group;lidocaine+sinomenine group rats were injected with 0.24 mL 1%lidocaine injection+0.095 mL sinomenine hydrochloride+2.9 mL 0.8 mL 0.8 mL in RSG,the rest was the same as model group.At the end of the eighth week of the experiment,the rats in the high-fat diet feeding group and the standard ordinary diet feeding group were given the medicine after there was significant difference in blood lipid;before the third injection of pituitrin,the ECG changes of the rats in each group were observed;the general situation of the rats before and after the administration was observed;after the experiment,the blood of the rats in each group was taken from the abdominal aorta,and the serum oxidative stress indexes,such as total superoxide dismutase(SOD)and malondialdehyde,were detected(MDA,IL-6 and cTnI were measured.Results:compared with the blank group,the ECG of the model group changed significantly(P<0.01),the cTnI value increased significantly(P<0.01),indicating that the rat myocardial ischemia model was successfully established;compared with the model group,the SOD level of lidocaine group and lidocaine+sinomenine group increased significantly(P<0.05,P<0.01),the MDA level decreased significantly(P<0.05,P<0.01),IL-6 decreased significantly(P<0.05,P<0.01)05,P<0.01).Conclusion:sinomenine SGB has protective effect on rats with chronic myocardial ischemia,which is related to anti oxidative stress and inhibition of inflammatory reaction.展开更多
AIM To investigate the efficacy and safety of stellate ganglion block for the treatment of patients with chronic ulcerative colitis.METHODS A total of 120 randomly selected patients with chronic ulcerative colitis tre...AIM To investigate the efficacy and safety of stellate ganglion block for the treatment of patients with chronic ulcerative colitis.METHODS A total of 120 randomly selected patients with chronic ulcerative colitis treated in Cangzhou Central Hospital from January 2014 to January 2016 were included in this study. These patients were divided into two groups: control group(n = 30), patients received oral sulfasalazine treatment; experimental group(n = 90), patients received stellate ganglion block treatment. Clinical symptoms and disease activity in these two groups were compared before and after treatment using endoscopy. Blood was collected from patients on day 0, 10, 20 and 30 after treatment. Enzyme-linked immunosorbent assay was performed to determine interleukin-8(IL-8) level. The changes in IL-8 level post-treatment in the two groups were compared using repeated measures analysis of variance.RESULTS After treatment, clinical symptoms and disease activity were shown to be alleviated by endoscopy in both the control and experimental groups. However, patients in the control group did not have obvious abdominal pain relief. In addition, the degree of pain relief in the experimental group was statistically better than that in the control group(P < 0.05). Ten days after treatment, IL-8 level was found to be significantly lower in the experimental group than in the control group, and the difference was statistically significant(P < 0.05). In addition, adverse events were significantly higher in the control group than in the experimental group, and the difference was statistically significant(χ~2 = 33.215, P = 0.000).CONCLUSION The application of stellate ganglion block effectively improves treatment efficacy in chronic ulcerative colitis, relieves clinical symptoms in patients, and reduces the level of inflammatory factors. Furthermore, this approach also had a positive impact on the disease to a certain extent.展开更多
Sympathetic system modulation by stellate ganglion blockade may modulate immune dysfunction and significantly improve symptoms of chronic ulcerative colitis.
Purpose: Whether or not right and left stellate ganglion blocks (SGB) affect blood pressure (BP) and heart rate (HR) differently has been controversial. The aim of this study was to analyze BP and HR changes after lar...Purpose: Whether or not right and left stellate ganglion blocks (SGB) affect blood pressure (BP) and heart rate (HR) differently has been controversial. The aim of this study was to analyze BP and HR changes after large numbers of right or left SGBs. Methods: A total of 16,404 right SGBs and 13,766 left SGBs were performed with 6 ml of 1% mepivacaine using the anterior paratracheal approach at C6. Changes in systolic BP and HR 30 min after SGBs were compared to the baseline values. Results: Systolic BP decreased by 25 to 49 mmHg in 10.93% and more than 50 mmHg in 0.67% of 16,404 right SGBs. Those percentages were significantly higher than corresponding percentages;8.43% and 0.49% of 13,766 left SGBs (P < 0.0001 and P < 0.05, respectively). On the other hand, systolic BP increased by 25-49 mmHg in 5.74% and more than 50 mmHg in 0.52% of left SGBs, and in 4.15% and 0.18% of right SGBs (P < 0.0001and P < 0.0001 between left and right SGBs, respectively). Right SGB caused marked reduction in HR (greater than 30 beats/min), more than left SGB (4.22% versus 2.70%, P Conclusions: Both right and left SGBs could produce clinically significant hypertension and hypotension, and also severe bradycardia. However, right SGB produces a higher incidence of significant reductions in systolic BP and HR, compared to left SGB. On the other hand, left SGB produces a significant increase in systolic BP compared to right SGB. Those differences likely stem from the hemispheric asymmetry in autonomic cardiovascular control.展开更多
To observe the therapeutic effect of different drugs used in stellate ganglion block (SGB) on migraine, 80 patients suffering from migraine were randomly allocated into two groups. In group A STB were treated with mix...To observe the therapeutic effect of different drugs used in stellate ganglion block (SGB) on migraine, 80 patients suffering from migraine were randomly allocated into two groups. In group A STB were treated with mixture of lidocaine, vitamine B complex and txiamcinolone acetonide, while in group B nimodipine was also added. The analgestic duration and effect were measured by double－blinded. The analgestic duration in groupB was significantly longer than in group A and the complete pain－relieving percentage was significantly high (P<0.05) in group B.展开更多
Recurrent Ventricular Tachycardia, or Electrical Storm, is a relatively common cause of mortality and morbidity after myocardial infarction. We present a case in which left stellate ganglion blocks were performed unde...Recurrent Ventricular Tachycardia, or Electrical Storm, is a relatively common cause of mortality and morbidity after myocardial infarction. We present a case in which left stellate ganglion blocks were performed under ultrasound guidance in order to alleviate recurrent ventricular tachycardia in a patient requiring extracorpeal membrane oxygenation after myocardial infarction. A medically complex 54-year-old male after two weeks removed from an acute ST elevation myocardial infarction status post stenting and intra-aortic balloon pump placement presented in the cardiovascular intensive care unit with recurrent unstable ventricular tachycardia while on extracorporeal membrane oxygenation and multiple vasoactive infusions. Our acute pain service was consulted by the cardiac electrophysiology service to provide left stellate ganglion blocks in attempt to attenuate electrical storm. Multiple single shot left stellate ganglion blocks were performed on subsequent days with increasing local anesthetic concentrations and volumes successfully providing temporary relief of electrical storm. A left stellate ganglion catheter was eventually placed, and a continuous infusion of local anesthesia was started. The patient experienced complete relief from unstable ventricular tachycardia and no further defibrillations were required. The catheter remained in place for 14 days allowing for extracorporeal membrane oxygenation decannulation without the return of electrical storm. We believe ultrasound guided left stellate ganglion blocks to be a relatively safe means to provide temporary relief of recurrent ventricular tachycardia.展开更多
Purpose: The aim of the current study was to investigate: 1) Whether there is an association between age and changes in systolic blood pressure (SBP) after stellate ganglion block (SGB), and 2) Whether gender plays a ...Purpose: The aim of the current study was to investigate: 1) Whether there is an association between age and changes in systolic blood pressure (SBP) after stellate ganglion block (SGB), and 2) Whether gender plays a role in hypotensive and hypertensive responses to SGB. Methods: We retrospectively reviewed SBP changes (ΔSBP) due to SGB, which were performed on 1641 subjects. SBP 30 min after SGB was compared to the baseline values. For the age study, average age of both sexes was calculated for six ranges of ΔSBP. For the gender study, the numbers of subjects (%) in various ranges of positive and negative values of ΔSBP were compared between men and women. Results: There was a significant association between age and both increasing (p Conclusions: There was an association between age and blood pressure changes after SGB and the association is most likely due to age-related alteration of cardiovascular functions. The different changes of SBP between men and women after SGB may well be attributable to gender differences of autonomic nervous regulation;sympathetic dominant man versus, parasympathetic dominant women.展开更多
BACKGROUND Awake fiberoptic nasotracheal intubation(AFNI)is the preferred airway ma-nagement strategy for patients with difficult airways.However,this procedure can cause significant physical and psychological distres...BACKGROUND Awake fiberoptic nasotracheal intubation(AFNI)is the preferred airway ma-nagement strategy for patients with difficult airways.However,this procedure can cause significant physical and psychological distress.This case report explores the application of a sphenopalatine ganglion(SPG)block as an alternative anal-gesic modality to mitigate the discomfort associated with AFNI.CASE SUMMARY A 63-year-old female with a history of right maxillary osteosarcoma underwent craniotomy for a suspected malignant brain lesion.The patient’s medical history included prior surgery,chemotherapy,and radiation therapy,resulting in signi-ficant jaw impairment and limited neck mobility.Considering the anticipated air-way challenges,AFNI was planned.A SPG block was performed under real-time ultrasound guidance,providing effective analgesia during nasotracheal intuba-tion.CONCLUSION The SPG block represents a promising analgesic approach in AFNI,offering po-tential benefits in alleviating pain involving the nasal and nasopharyngeal regions as well as improving patient cooperation.展开更多
BACKGROUND Atrial arrhythmias such as paroxysmal supraventricular tachycardia(PSVT)and atrial flutter(AF)are common in the perioperative setting.They commonly resolve spontaneously.However,occasionally,they may contin...BACKGROUND Atrial arrhythmias such as paroxysmal supraventricular tachycardia(PSVT)and atrial flutter(AF)are common in the perioperative setting.They commonly resolve spontaneously.However,occasionally,they may continually progress to fatal arrhythmias or cause complications.Therefore,prompt and appropriate management is important.CASE SUMMARY A 46-year-old female patient diagnosed with cervical C6-7 radiculopathy characterized by decreased sensation in the right third,fourth and fifth fingers underwent C6-7 anterior cervical disc fusion surgery.Electrocardiography showed PSVT and ventricular tachycardia during C6-7 disc retraction.However,the patient remained stable.Initial treatment with esmolol and lidocaine for ventricular tachycardia was ineffective.Carotid massage and Valsalva maneuver were attempted but PSVT did not resolve.The surgery was paused,and the patient’s fraction of inspired oxygen was set to 100%.Adenosine was administered for pharmacological management of PSVT.The arrhythmia temporarily resolved.However,it then transformed into AF.Diltiazem was administered,which briefly decreased blood pressure,which immediately recovered.Surgery resumed while the patient was in normal sinus rhythm.She was discharged safely on postoperative day 6 without complications or abnormalities.Currently,she is living a healthy life without arrhythmia recurrence.CONCLUSION Ganglia associated with cardiac arrhythmias in the surgical site should be identified during cervical spine surgery.展开更多
BACKGROUND: At present, inhalation of nitrogen monoxidum (NO) or other angiotenic is widely used to cure hypoxic pulmonary artery hypertension. In addition, recent researches demonstrate that postganglionic fiber of s...BACKGROUND: At present, inhalation of nitrogen monoxidum (NO) or other angiotenic is widely used to cure hypoxic pulmonary artery hypertension. In addition, recent researches demonstrate that postganglionic fiber of stellate ganglion can regulate contents of blood vessel endothelium-calcitonin gene-related peptide (BVE-CGRP) and nitricoxide synthase (NOS) in lung tissue. Therefore, stellate ganglion which is blocked with the local anesthetic may cause therapeutic effects on hypoxic pulmonary artery hypertension. OBJECTIVE: To observe the effects of stellate block on calcitonin gene-related peptide (CGRP) of vasodilation factors, prostacyclin, endothelin-1 of vasoconstriction factors, thromboxan, blood vessel endothelium-nitricoxide synthase (BVE-NOS) and mean arterial pressure of lung tissue in rabbits with hypoxic pulmonary artery hypertension. DESIGN: Randomly controlled animal study. SETTING: Neurological Institute of Taihe Hospital Affiliated to Yunyang Medical College. MATERIALS: A total of 24 adult Japanese rabbits of both genders and weighing 2.3–2.6 kg were provided by Animal Experimental Center of Hubei Academy of Medical Science. SP kit was provided by Beijing Zhongshan Biotechnology Co., Ltd.; moreover, kits of endothelin-1, CGRP, prostacyclin and thromboxan were provided by Radioimmunity Institute, Scientific and Technological Developing Center, General Hospital of Chinese PLA, and color image analytical system (Leica-Q500IW) was made in Germany. METHODS: The experiment was carried out in the Neurological Institute of Taihe Hospital affiliated to Yunyang Medical College from February to December 2002. ① Rabbits were performed with aseptic manipulation to exposure left stellate ganglion and then it was put in epidural catheter for 1 week. In addition, one end of epidural catheter was fixed near by stellate ganglion and the other end was fixed through dorsal neck. All rabbits were randomly divided into 4 groups, including normal control group, stellate block group, hypoxia group and hypoxia + stellate block group, with 6 in each group. Rabbits in the normal control group were perfused with saline through epidural catheter with 0.5 mL once for three times per day and 3 successive days in total; in addition, rabbits in the stellate block group were perfused with 2.5 g/L bupivacaine through epidural catheter with 0.5 mL once for three times per day and 3 successive days in total. Rabbits in the hypoxia group were used to establish hypoxic pulmonary artery hypertension models. That was to say, the experimental rabbits were put in hypoxic box (containing sodalime and calcium chloride to absorb CO2 and water) and given various flows of oxygen and nitrogen through the two lateral wells simultaneously. And then, oxygen was monitored with oxygen-concentration monitoring device to control the concentration in (10±2)% for 8 hours per day and 2 successive weeks in total. Rabbits in the hypoxia + stellate block group were used to establish hypoxia models as the same as those in the hypoxia group. Two weeks later, 2.5 g/L bupivacaine was pushed into epidural catheter with 0.5 mL once for three times per day and 3 successive days in total. Breast was directly opened to measure mean pulmonary artery pressure. ② 6 mL blood was collected through pulmonary arterial duct to measure levels of plasma CGRP, prostacyclin, endothelin-1 and thromboxane with radio-immunity technique; meanwhile, immunohistochemical staining was used to observe the changes of BVE-NOS content of the experimental rabbits in all groups. MAIN OUTCOME MEASURES: Changes of CGRP, prostacyclin, endothelin-1 and thromboxane and BVE-NOS. RESULTS: A total of 24 experimental rabbits were involved in the final analysis. ① As compared withthose in the normal control group, hypoxic pulmonary artery hypertension of the experimental rabbits was higher in the hypoxia group and hypoxia + stellate block group after hypoxia [(3.84±0.30), (3.16±0.45), (2.60±0.27) kPa, P < 0.05, 0.01]; CGRP was lower [(68.20±8.78), (108.24±14.35), (130.25±22.70) ng/L, P < 0.05, 0.01]; prostacyclin was lower [(94.45±10.68), (98.77±12.31), (155.27±20.67) ng/L, P < 0.01]; endothelin-1 was higher [(184.74±29.66), (115.27±13.62), (98.20±11.52), ng/L, P < 0.05, 0.01]; thromboxan was higher [(226.27±30.46), (207.67±27.32), (124.25±16.89) ng/L, P < 0.01]. As compared with that in hypoxia group, hypoxic pulmonary artery hypertension was decreased in hypoxia + stellate block group (P < 0.05), CGRP was increased (P < 0.01), and endothelin-1 was decreased remarkably (P < 0.05). ② Level of BVE-NOS of the experimental rabbits was higher in stellate block group, hypoxia group and hypoxia + stellate block group than that in the normal control group [(0.25±0.06), (0.27±0.07), (0.46± 0.12), (0.14±0.03), P < 0.05], and NOS level was higher in the hypoxia + stellate block group than that in hypoxia group (P < 0.05). CONCLUSION: Mean arterial pressure is decreased in rabbits with hypoxic pulmonary artery hypertension after stellate block and level of endothelin-1 is also decreased; however, levels of CGRP and NOS are increased respectively.展开更多
Background: Post dural puncture headache (PDPH) is a known and potentially debilitating complication of neuraxial anesthesia that can impede patient recovery. The conventional treatment includes hydration and symptoma...Background: Post dural puncture headache (PDPH) is a known and potentially debilitating complication of neuraxial anesthesia that can impede patient recovery. The conventional treatment includes hydration and symptomatic treatment like simple analgesics. Those who have unremitting symptoms following conservative measures are offered an epidural blood patch (EBP). However, EBP, an invasive procedure, is associated with complications in itself. Case: We report a 40-year-old man who experienced PDPH after spinal anesthesia. His symptoms recurred after conservative management was instituted. He was then offered a trans-nasal sphenopalatine ganglion (SPG) block. He had excellent pain relief and did not require an EBP. Conclusion: SPG blocks can be considered early in the treatment of PDPH together with general supportive measures. However, if pain relief is not achieved, an epidural blood patch should still be considered.展开更多
In this study, we investigated the possible involvement of nitric oxide pathways in the presynaptic inhibition of acetylcholine release induced by ATP analogs in dogs. We performed the study using HPLC with electroche...In this study, we investigated the possible involvement of nitric oxide pathways in the presynaptic inhibition of acetylcholine release induced by ATP analogs in dogs. We performed the study using HPLC with electrochemical detection and the nitric oxide detection-HPLC system. The amount of acetylcholine released in response to preganglionic stimulation at 5 Hz for 10 min was reduced in a concentration-dependent manner after exposure to 10-7 - 10-4 M α,β-methylene-ATP (α,β-meATP), but not by the P2Y receptor agonist, 2-methyl-thio-ATP (2MeSATP) or the P2X1 receptor agonist, β,γ-methylene-ATP (β,γ-meATP), at the same concentrations. The inhibition of acetylcholine release induced by α,β-meATP was antagonized by: the nonselective P2 receptor antagonist, pyridoxalphosphate-6-azophenyl-2’,4’-disulphonic acid (PPADS);the P2X1, P2X3 and P2X2/3 receptors antagonist, 2’-(or-3’)-O-trinitrophenyl-ATP (TNP-ATP);the neuronal nitric oxide synthase (nNOS) inhibitor, 3-bromo-7-nitroindazole;the soluble guanylyl cyclase inhibitor, 1H-[1,2,4]oxadiazolo[4,3-a]quinoxalin-1-one (ODQ);the NO scavenger, 2-(4-carboxyphenyl)-4,4,5,5-tetramethy-limidazoline-1-oxyl-3-oxide (carboxy-PTIO). Exposure to 10-5 M, but not 10-4 M, α,β-meATP, for 30 min increased the levels of , and this increase was antagonized by TNP-ATP and 3-bromo-7-nitroindazole. These results show that P2X receptor activation inhibits stellate ganglionic transmission by reducing acetylcholine release from presynaptic nerve terminals and that this inhibition seems to involve, at least in part, the activation of endogenous NO production and cGMP pathways.展开更多
Objective: To understand an unusual complication of a low risk procedure. Design: This article chronicles the side effect of a Ganglion Impar Block. Setting: Loyola University Medical Center Outpatient Chronic Pain Cl...Objective: To understand an unusual complication of a low risk procedure. Design: This article chronicles the side effect of a Ganglion Impar Block. Setting: Loyola University Medical Center Outpatient Chronic Pain Clinic. Patients: One. Results: Our patient had tachycardia after a Ganglion Impar Block. Conclusions: An unusual complication of a ganglion impar block can be increased heart rate.展开更多
基金The study was approved by Postdoctoral Scientific Research Developmental Fund of Heilongjiang Province,No.LBH-Q18074(to WCY).
文摘Diabetes mellitus is an independent risk factor for ischemic stroke.Both diabetes mellitus and stroke are linked to systemic inflammation that aggravates patient outcomes.Stellate ganglion block can effectively regulate the inflammatory response.Therefore,it is hypothesized that stellate ganglion block could be a potential therapy for ischemic stroke in diabetic subjects.In this study,we induced diabetes mellitus in rats by feeding them a high-fat diet for 4 successive weeks.The left middle cerebral artery was occluded to establish models of ischemic stroke in diabetic rats.Subsequently,we performed left stellate ganglion block with 1%lidocaine using the percutaneous posterior approach 15 minutes before reperfusion and again 20 and 44 hours after reperfusion.Our results showed that stellate ganglion block did not decrease the blood glucose level in diabetic rats with diabetes mellitus but did reduce the cerebral infarct volume and the cerebral water content.It also improved the recovery of neurological function,increased 28-day survival rate,inhibited Toll like receptor 4/nuclear factor kappa B signaling pathway and reduced inflammatory response in the plasma of rats.However,injection of Toll like receptor 4 agonist lipopolysaccharide 5 minutes before stellate ganglion block inhibited the effect of stellate ganglion block,whereas injection of Toll like receptor 4 inhibitor TAK242 had no such effect.We also found that stellate ganglion block performed at night had no positive effect on diabetic ischemic stroke.These findings suggest that stellate ganglion block is a potential therapy for diabetic ischemic stroke and that it may be mediated through the Toll like receptor 4/nuclear factor kappa B signaling pathway.We also found that the therapeutic effect of stellate ganglion block is affected by circadian rhythm.
基金National Administration of traditional Chinese medicine base project(No.jdzx2012144,jdzx2015253)Shaanxi provincial major disease TCM innovation plan:chest obstruction(coronary heart disease)+1 种基金Shaanxi Provincial Administration of traditional Chinese medicine scientific research project(No.15-scjh015,15-lc016,lcpt089,15-scjh016)discipline innovation team of the Second Affiliated Hospital of Shaanxi University of Chinese medicine(No.2020xktd-b03)。
文摘Objective:To investigate the protective effect of sinomenine stellate ganglion block(SGB)on chronic myocardial ischemia and its related mechanism.Methods:SD male and female rats(180~200g)were randomly divided into four groups:blank group,model group,lidocaine group,lidocaine+sinomenine group.The rats in blank group were fed with normal standard diet without modeling,and the other rats were fed with high-fat diet.After 8 weeks of feeding,the rats in high-fat diet group were significantly different from those in blank control group.Then they were randomly divided into 3 groups,10 rats in model group were injected with 0.9%NaCl into right stellate ganglion(RSG)After 2 weeks of continuous injection,pituitrin injection was continuously injected into sublingual vein of rats for 3 days,once every 24 hours;lidocaine group rats were injected with 0.24 mL 1%lidocaine injection in RSG,the rest was the same as model group;lidocaine+sinomenine group rats were injected with 0.24 mL 1%lidocaine injection+0.095 mL sinomenine hydrochloride+2.9 mL 0.8 mL 0.8 mL in RSG,the rest was the same as model group.At the end of the eighth week of the experiment,the rats in the high-fat diet feeding group and the standard ordinary diet feeding group were given the medicine after there was significant difference in blood lipid;before the third injection of pituitrin,the ECG changes of the rats in each group were observed;the general situation of the rats before and after the administration was observed;after the experiment,the blood of the rats in each group was taken from the abdominal aorta,and the serum oxidative stress indexes,such as total superoxide dismutase(SOD)and malondialdehyde,were detected(MDA,IL-6 and cTnI were measured.Results:compared with the blank group,the ECG of the model group changed significantly(P<0.01),the cTnI value increased significantly(P<0.01),indicating that the rat myocardial ischemia model was successfully established;compared with the model group,the SOD level of lidocaine group and lidocaine+sinomenine group increased significantly(P<0.05,P<0.01),the MDA level decreased significantly(P<0.05,P<0.01),IL-6 decreased significantly(P<0.05,P<0.01)05,P<0.01).Conclusion:sinomenine SGB has protective effect on rats with chronic myocardial ischemia,which is related to anti oxidative stress and inhibition of inflammatory reaction.
文摘AIM To investigate the efficacy and safety of stellate ganglion block for the treatment of patients with chronic ulcerative colitis.METHODS A total of 120 randomly selected patients with chronic ulcerative colitis treated in Cangzhou Central Hospital from January 2014 to January 2016 were included in this study. These patients were divided into two groups: control group(n = 30), patients received oral sulfasalazine treatment; experimental group(n = 90), patients received stellate ganglion block treatment. Clinical symptoms and disease activity in these two groups were compared before and after treatment using endoscopy. Blood was collected from patients on day 0, 10, 20 and 30 after treatment. Enzyme-linked immunosorbent assay was performed to determine interleukin-8(IL-8) level. The changes in IL-8 level post-treatment in the two groups were compared using repeated measures analysis of variance.RESULTS After treatment, clinical symptoms and disease activity were shown to be alleviated by endoscopy in both the control and experimental groups. However, patients in the control group did not have obvious abdominal pain relief. In addition, the degree of pain relief in the experimental group was statistically better than that in the control group(P < 0.05). Ten days after treatment, IL-8 level was found to be significantly lower in the experimental group than in the control group, and the difference was statistically significant(P < 0.05). In addition, adverse events were significantly higher in the control group than in the experimental group, and the difference was statistically significant(χ~2 = 33.215, P = 0.000).CONCLUSION The application of stellate ganglion block effectively improves treatment efficacy in chronic ulcerative colitis, relieves clinical symptoms in patients, and reduces the level of inflammatory factors. Furthermore, this approach also had a positive impact on the disease to a certain extent.
文摘Sympathetic system modulation by stellate ganglion blockade may modulate immune dysfunction and significantly improve symptoms of chronic ulcerative colitis.
文摘Purpose: Whether or not right and left stellate ganglion blocks (SGB) affect blood pressure (BP) and heart rate (HR) differently has been controversial. The aim of this study was to analyze BP and HR changes after large numbers of right or left SGBs. Methods: A total of 16,404 right SGBs and 13,766 left SGBs were performed with 6 ml of 1% mepivacaine using the anterior paratracheal approach at C6. Changes in systolic BP and HR 30 min after SGBs were compared to the baseline values. Results: Systolic BP decreased by 25 to 49 mmHg in 10.93% and more than 50 mmHg in 0.67% of 16,404 right SGBs. Those percentages were significantly higher than corresponding percentages;8.43% and 0.49% of 13,766 left SGBs (P < 0.0001 and P < 0.05, respectively). On the other hand, systolic BP increased by 25-49 mmHg in 5.74% and more than 50 mmHg in 0.52% of left SGBs, and in 4.15% and 0.18% of right SGBs (P < 0.0001and P < 0.0001 between left and right SGBs, respectively). Right SGB caused marked reduction in HR (greater than 30 beats/min), more than left SGB (4.22% versus 2.70%, P Conclusions: Both right and left SGBs could produce clinically significant hypertension and hypotension, and also severe bradycardia. However, right SGB produces a higher incidence of significant reductions in systolic BP and HR, compared to left SGB. On the other hand, left SGB produces a significant increase in systolic BP compared to right SGB. Those differences likely stem from the hemispheric asymmetry in autonomic cardiovascular control.
文摘To observe the therapeutic effect of different drugs used in stellate ganglion block (SGB) on migraine, 80 patients suffering from migraine were randomly allocated into two groups. In group A STB were treated with mixture of lidocaine, vitamine B complex and txiamcinolone acetonide, while in group B nimodipine was also added. The analgestic duration and effect were measured by double－blinded. The analgestic duration in groupB was significantly longer than in group A and the complete pain－relieving percentage was significantly high (P<0.05) in group B.
文摘Recurrent Ventricular Tachycardia, or Electrical Storm, is a relatively common cause of mortality and morbidity after myocardial infarction. We present a case in which left stellate ganglion blocks were performed under ultrasound guidance in order to alleviate recurrent ventricular tachycardia in a patient requiring extracorpeal membrane oxygenation after myocardial infarction. A medically complex 54-year-old male after two weeks removed from an acute ST elevation myocardial infarction status post stenting and intra-aortic balloon pump placement presented in the cardiovascular intensive care unit with recurrent unstable ventricular tachycardia while on extracorporeal membrane oxygenation and multiple vasoactive infusions. Our acute pain service was consulted by the cardiac electrophysiology service to provide left stellate ganglion blocks in attempt to attenuate electrical storm. Multiple single shot left stellate ganglion blocks were performed on subsequent days with increasing local anesthetic concentrations and volumes successfully providing temporary relief of electrical storm. A left stellate ganglion catheter was eventually placed, and a continuous infusion of local anesthesia was started. The patient experienced complete relief from unstable ventricular tachycardia and no further defibrillations were required. The catheter remained in place for 14 days allowing for extracorporeal membrane oxygenation decannulation without the return of electrical storm. We believe ultrasound guided left stellate ganglion blocks to be a relatively safe means to provide temporary relief of recurrent ventricular tachycardia.
文摘Purpose: The aim of the current study was to investigate: 1) Whether there is an association between age and changes in systolic blood pressure (SBP) after stellate ganglion block (SGB), and 2) Whether gender plays a role in hypotensive and hypertensive responses to SGB. Methods: We retrospectively reviewed SBP changes (ΔSBP) due to SGB, which were performed on 1641 subjects. SBP 30 min after SGB was compared to the baseline values. For the age study, average age of both sexes was calculated for six ranges of ΔSBP. For the gender study, the numbers of subjects (%) in various ranges of positive and negative values of ΔSBP were compared between men and women. Results: There was a significant association between age and both increasing (p Conclusions: There was an association between age and blood pressure changes after SGB and the association is most likely due to age-related alteration of cardiovascular functions. The different changes of SBP between men and women after SGB may well be attributable to gender differences of autonomic nervous regulation;sympathetic dominant man versus, parasympathetic dominant women.
文摘BACKGROUND Awake fiberoptic nasotracheal intubation(AFNI)is the preferred airway ma-nagement strategy for patients with difficult airways.However,this procedure can cause significant physical and psychological distress.This case report explores the application of a sphenopalatine ganglion(SPG)block as an alternative anal-gesic modality to mitigate the discomfort associated with AFNI.CASE SUMMARY A 63-year-old female with a history of right maxillary osteosarcoma underwent craniotomy for a suspected malignant brain lesion.The patient’s medical history included prior surgery,chemotherapy,and radiation therapy,resulting in signi-ficant jaw impairment and limited neck mobility.Considering the anticipated air-way challenges,AFNI was planned.A SPG block was performed under real-time ultrasound guidance,providing effective analgesia during nasotracheal intuba-tion.CONCLUSION The SPG block represents a promising analgesic approach in AFNI,offering po-tential benefits in alleviating pain involving the nasal and nasopharyngeal regions as well as improving patient cooperation.
基金Supported by The Research fund from Chosun University Hospital.
文摘BACKGROUND Atrial arrhythmias such as paroxysmal supraventricular tachycardia(PSVT)and atrial flutter(AF)are common in the perioperative setting.They commonly resolve spontaneously.However,occasionally,they may continually progress to fatal arrhythmias or cause complications.Therefore,prompt and appropriate management is important.CASE SUMMARY A 46-year-old female patient diagnosed with cervical C6-7 radiculopathy characterized by decreased sensation in the right third,fourth and fifth fingers underwent C6-7 anterior cervical disc fusion surgery.Electrocardiography showed PSVT and ventricular tachycardia during C6-7 disc retraction.However,the patient remained stable.Initial treatment with esmolol and lidocaine for ventricular tachycardia was ineffective.Carotid massage and Valsalva maneuver were attempted but PSVT did not resolve.The surgery was paused,and the patient’s fraction of inspired oxygen was set to 100%.Adenosine was administered for pharmacological management of PSVT.The arrhythmia temporarily resolved.However,it then transformed into AF.Diltiazem was administered,which briefly decreased blood pressure,which immediately recovered.Surgery resumed while the patient was in normal sinus rhythm.She was discharged safely on postoperative day 6 without complications or abnormalities.Currently,she is living a healthy life without arrhythmia recurrence.CONCLUSION Ganglia associated with cardiac arrhythmias in the surgical site should be identified during cervical spine surgery.
基金the Key Technology Development Foundation of Hubei Province, No. 20002B33
文摘BACKGROUND: At present, inhalation of nitrogen monoxidum (NO) or other angiotenic is widely used to cure hypoxic pulmonary artery hypertension. In addition, recent researches demonstrate that postganglionic fiber of stellate ganglion can regulate contents of blood vessel endothelium-calcitonin gene-related peptide (BVE-CGRP) and nitricoxide synthase (NOS) in lung tissue. Therefore, stellate ganglion which is blocked with the local anesthetic may cause therapeutic effects on hypoxic pulmonary artery hypertension. OBJECTIVE: To observe the effects of stellate block on calcitonin gene-related peptide (CGRP) of vasodilation factors, prostacyclin, endothelin-1 of vasoconstriction factors, thromboxan, blood vessel endothelium-nitricoxide synthase (BVE-NOS) and mean arterial pressure of lung tissue in rabbits with hypoxic pulmonary artery hypertension. DESIGN: Randomly controlled animal study. SETTING: Neurological Institute of Taihe Hospital Affiliated to Yunyang Medical College. MATERIALS: A total of 24 adult Japanese rabbits of both genders and weighing 2.3–2.6 kg were provided by Animal Experimental Center of Hubei Academy of Medical Science. SP kit was provided by Beijing Zhongshan Biotechnology Co., Ltd.; moreover, kits of endothelin-1, CGRP, prostacyclin and thromboxan were provided by Radioimmunity Institute, Scientific and Technological Developing Center, General Hospital of Chinese PLA, and color image analytical system (Leica-Q500IW) was made in Germany. METHODS: The experiment was carried out in the Neurological Institute of Taihe Hospital affiliated to Yunyang Medical College from February to December 2002. ① Rabbits were performed with aseptic manipulation to exposure left stellate ganglion and then it was put in epidural catheter for 1 week. In addition, one end of epidural catheter was fixed near by stellate ganglion and the other end was fixed through dorsal neck. All rabbits were randomly divided into 4 groups, including normal control group, stellate block group, hypoxia group and hypoxia + stellate block group, with 6 in each group. Rabbits in the normal control group were perfused with saline through epidural catheter with 0.5 mL once for three times per day and 3 successive days in total; in addition, rabbits in the stellate block group were perfused with 2.5 g/L bupivacaine through epidural catheter with 0.5 mL once for three times per day and 3 successive days in total. Rabbits in the hypoxia group were used to establish hypoxic pulmonary artery hypertension models. That was to say, the experimental rabbits were put in hypoxic box (containing sodalime and calcium chloride to absorb CO2 and water) and given various flows of oxygen and nitrogen through the two lateral wells simultaneously. And then, oxygen was monitored with oxygen-concentration monitoring device to control the concentration in (10±2)% for 8 hours per day and 2 successive weeks in total. Rabbits in the hypoxia + stellate block group were used to establish hypoxia models as the same as those in the hypoxia group. Two weeks later, 2.5 g/L bupivacaine was pushed into epidural catheter with 0.5 mL once for three times per day and 3 successive days in total. Breast was directly opened to measure mean pulmonary artery pressure. ② 6 mL blood was collected through pulmonary arterial duct to measure levels of plasma CGRP, prostacyclin, endothelin-1 and thromboxane with radio-immunity technique; meanwhile, immunohistochemical staining was used to observe the changes of BVE-NOS content of the experimental rabbits in all groups. MAIN OUTCOME MEASURES: Changes of CGRP, prostacyclin, endothelin-1 and thromboxane and BVE-NOS. RESULTS: A total of 24 experimental rabbits were involved in the final analysis. ① As compared withthose in the normal control group, hypoxic pulmonary artery hypertension of the experimental rabbits was higher in the hypoxia group and hypoxia + stellate block group after hypoxia [(3.84±0.30), (3.16±0.45), (2.60±0.27) kPa, P < 0.05, 0.01]; CGRP was lower [(68.20±8.78), (108.24±14.35), (130.25±22.70) ng/L, P < 0.05, 0.01]; prostacyclin was lower [(94.45±10.68), (98.77±12.31), (155.27±20.67) ng/L, P < 0.01]; endothelin-1 was higher [(184.74±29.66), (115.27±13.62), (98.20±11.52), ng/L, P < 0.05, 0.01]; thromboxan was higher [(226.27±30.46), (207.67±27.32), (124.25±16.89) ng/L, P < 0.01]. As compared with that in hypoxia group, hypoxic pulmonary artery hypertension was decreased in hypoxia + stellate block group (P < 0.05), CGRP was increased (P < 0.01), and endothelin-1 was decreased remarkably (P < 0.05). ② Level of BVE-NOS of the experimental rabbits was higher in stellate block group, hypoxia group and hypoxia + stellate block group than that in the normal control group [(0.25±0.06), (0.27±0.07), (0.46± 0.12), (0.14±0.03), P < 0.05], and NOS level was higher in the hypoxia + stellate block group than that in hypoxia group (P < 0.05). CONCLUSION: Mean arterial pressure is decreased in rabbits with hypoxic pulmonary artery hypertension after stellate block and level of endothelin-1 is also decreased; however, levels of CGRP and NOS are increased respectively.
文摘Background: Post dural puncture headache (PDPH) is a known and potentially debilitating complication of neuraxial anesthesia that can impede patient recovery. The conventional treatment includes hydration and symptomatic treatment like simple analgesics. Those who have unremitting symptoms following conservative measures are offered an epidural blood patch (EBP). However, EBP, an invasive procedure, is associated with complications in itself. Case: We report a 40-year-old man who experienced PDPH after spinal anesthesia. His symptoms recurred after conservative management was instituted. He was then offered a trans-nasal sphenopalatine ganglion (SPG) block. He had excellent pain relief and did not require an EBP. Conclusion: SPG blocks can be considered early in the treatment of PDPH together with general supportive measures. However, if pain relief is not achieved, an epidural blood patch should still be considered.
文摘In this study, we investigated the possible involvement of nitric oxide pathways in the presynaptic inhibition of acetylcholine release induced by ATP analogs in dogs. We performed the study using HPLC with electrochemical detection and the nitric oxide detection-HPLC system. The amount of acetylcholine released in response to preganglionic stimulation at 5 Hz for 10 min was reduced in a concentration-dependent manner after exposure to 10-7 - 10-4 M α,β-methylene-ATP (α,β-meATP), but not by the P2Y receptor agonist, 2-methyl-thio-ATP (2MeSATP) or the P2X1 receptor agonist, β,γ-methylene-ATP (β,γ-meATP), at the same concentrations. The inhibition of acetylcholine release induced by α,β-meATP was antagonized by: the nonselective P2 receptor antagonist, pyridoxalphosphate-6-azophenyl-2’,4’-disulphonic acid (PPADS);the P2X1, P2X3 and P2X2/3 receptors antagonist, 2’-(or-3’)-O-trinitrophenyl-ATP (TNP-ATP);the neuronal nitric oxide synthase (nNOS) inhibitor, 3-bromo-7-nitroindazole;the soluble guanylyl cyclase inhibitor, 1H-[1,2,4]oxadiazolo[4,3-a]quinoxalin-1-one (ODQ);the NO scavenger, 2-(4-carboxyphenyl)-4,4,5,5-tetramethy-limidazoline-1-oxyl-3-oxide (carboxy-PTIO). Exposure to 10-5 M, but not 10-4 M, α,β-meATP, for 30 min increased the levels of , and this increase was antagonized by TNP-ATP and 3-bromo-7-nitroindazole. These results show that P2X receptor activation inhibits stellate ganglionic transmission by reducing acetylcholine release from presynaptic nerve terminals and that this inhibition seems to involve, at least in part, the activation of endogenous NO production and cGMP pathways.
文摘Objective: To understand an unusual complication of a low risk procedure. Design: This article chronicles the side effect of a Ganglion Impar Block. Setting: Loyola University Medical Center Outpatient Chronic Pain Clinic. Patients: One. Results: Our patient had tachycardia after a Ganglion Impar Block. Conclusions: An unusual complication of a ganglion impar block can be increased heart rate.
