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By summarizing and analyzing the research status of the influence of needling different acupoints on heart rate variability (HRV) and autonomic nervous function, it is found that Neiguan (PC 6), Zusanli (ST 36) and Shenmen (HT 7) are common acupoints for HRV analysis involving Tongli (HT 5), Hegu (LI 4), Taichong (LR 3), Zhongwan (RN 12), Danzhong (RN 17), Xinshu (BL 15), Shenshu (BL 23) and other acupoints. Different acupoints have different influences on HRV but followed by some rules, which are possibly related to the efficacy of acupoints, meridian tropism and acupoint distributions. Needling on the same acupoint also has different influences on HRV, which is possibly affected by sample size, intervention object, data processing method and other factors, so more standardized measurement process is required in further studies.
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Abstract Background Dexmedetomidine (Dex) is widely used, and its most common side effect is bradycardia. The complete mechanism through which Dex induces bradycardia has not been elucidated. This research investigates the expression of gap junction proteins Connexin30.2 (Cx30.2) and Connexin40 (Cx40) within the sinoatrial node of rats with Dex-induced sinus bradycardia. Methods Eighty rats were randomly assigned to five groups. Saline was administered to rats in Group C. In the other four groups, the rats were administered Dex to induce bradycardia. In groups D1and D2, the rats were administered Dex at a loading dose of 30 μg.kg−1 and 100 μg.kg−1 for 10 min, then at 15 μg.kg−1.h−1 and 50 μg.kg−1.h−1 for 120 min separately. The rats in group D1A and D2A were administered Dex in the same way as in group D1and D2; however, immediately after the administration of the loading dose, 0.5 mg atropine was administered intravenously, and then at 0.5 mg.kg−1.h−1 for 120 min. The sinoatrial node was acquired after intravenous infusion was completed. Quantitative real-time polymerase chain reaction and western blot analyses were performed to measure mRNA and protein expression of Cx30.2 and Cx40, respectively. Results The expression of Cx30.2 increased, whereas the expression of Cx40 decreased within the sinoatrial node of rats with Dex-induced sinus bradycardia. Atropine reversed the effects of Dex on the expression of gap junction proteins. Conclusion Dex possibly altered the expression of gap junction proteins to slow down cardiac conduction velocity in the sinoatrial node.
Subject(s)
Animals , Rats , Sinoatrial Node/metabolism , Dexmedetomidine , Arrhythmias, Cardiac , Atropine Derivatives/metabolism , Bradycardia/chemically induced , Connexins/genetics , Connexins/metabolismABSTRACT
Alzheimer's disease (AD) is one of the most common neurodegenerative diseases in the elderly. The aim of this study was to explore the effects of AD on cardiac function and autonomic nervous function, and the feasibility of electrocardiogram (ECG) in monitoring the development of AD. APP/PS1 double transgenic mice were used in the Morris water maze (MWM) experiment to evaluate the changes of cognitive ability of AD mice, then the non-invasive ECG acquisition system was used and the changes of ECG intervals and heart rate variability (HRV) were analyzed. AD mice already had cognitive dysfunction at the age of 5 months, reaching the level of mild dementia, and the degree of dementia increased with the course of disease. There were no significant changes in ECG intervals in the AD group at each month. The mean square of successive RR interval differences, percentage of intervals >6 ms different from preceding interval, and normalized high frequency power component in the AD group were decreased and low-to-high frequency power ratio and normalized low frequency power component were increased. Combined with the results of the MWM, it was shown that the regulation mechanism of sympathetic and parasympathetic nerves in mice was already imbalanced in early stage AD, which was manifested as the increase of excessive activity of sympathetic nerves and the inhibition of parasympathetic activities. Therefore, ECG-based analysis of HRV may become a means of daily monitoring of AD and provide an auxiliary basis for clinical diagnosis.
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Objective:To investigate the 12-lead electrocardiogram findings and their clinical significance in children with orthostatic hypertension (OHT), providing evidence for clinical diagnosis and treatment of OTH.Methods:Thirty-four children with OHT who received diagnosis and treatment in the Zhuji Second People's Hospital from January 2017 to December 2019 were included in the OHT group. An additional 34 healthy children who concurrently received routine physical examination were included in the control group. Both groups of children underwent a 12-lead electrocardiogram in lying and standing positions. The changes in ST-segment and T-wave amplitudes in the lying position relative to the standing position were compared between the two groups.Results:The changes in T-wave amplitude of leads II, V 5, and V 6 in the OHT group were (0.07 ± 0.11) mV, (0.13 ± 0.12) mV, and (0.14 ± 0.11) mV, respectively, which were significantly higher than those in the control group [(0.02 ± 0.07) mV, (0.05 ± 0.06) mV, (0.03 ± 0.04) mV, t = 2.24, 3.48, 5.48, P = 0.029, 0.001, < 0.001). There were no significant differences in the changes in T-wave amplitude of other leads between the two groups (all P > 0.05). There was no significant difference in change in ST-segment amplitude on 12-lead electrocardiogram images between the two groups (all P > 0.05). The area under the curve of the changes in T-wave amplitude of leads II and V 5 in predicting OHT in children was 0.596 and 0.672 respectively, the sensitivity was 64.71% and 55.88%, respectively, and the specificity was 70.59% and 61.76%, respectively. The changes in T-wave amplitude of leads II and V 5 had low efficacy in predicting OHT in children. The area under the curve of the change in T-wave amplitude of lead V 6 in predicting OHT in children was 0.738, and the sensitivity and specificity were 76.47% and 67.65%, respectively. The change in T-wave amplitude of lead V 6 had moderate efficacy for predicting OHT in children. Conclusion:The changes in T-wave amplitude of lead V 6 on the electrocardiogram image taken in the lying position relative to the standing position are of certain value in predicting OHT in children. The 12-lead electrocardiogram can provide important evidence for clinical prediction and diagnosis of OHT in children.
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Rectal cancer is a common malignant tumor of the digestive tract, and surgery is the main treatment strategy. Disorders of bowel, anorectal and urogenital function remain common problems after total mesorectal resection (TME), which seriously decreases the quality of life of patients. Surgical nerve damage is one of the main causes of the complications, while TME with pelvic autonomic nerve preservation is an effective way to reduce the occurrence of adverse outcomes. Intraoperative nerve monitoring (IONM) is a promising method to assist the surgeon to identify and protect the pelvic autonomic nerves. Nevertheless, the monitoring methods and technical standards vary, and the clinical use of IONM is still limited. This review aims to summarize the researches on IONM in rectal and pelvic surgery. The electrical nerve stimulation technique and different methods of IONM in rectal cancer surgery are introduced. Also, the authors discuss the limitations of current researches, including methodological disunity and lack of equipment, then prospect the future direction in this field.
Subject(s)
Humans , Autonomic Pathways , Pelvis/surgery , Quality of Life , Rectal Neoplasms/surgery , Rectum/surgeryABSTRACT
Children and adolescents with orthostatic intolerance (OI) have autonomic nervous dysfunction.The autonomic nervous system is closely related to the cardiovascular system, and autonomic nervous dysfunction can cause changes in electrocardiographic (ECG) indexes, including the heart rate variability (HRV), ventricular late potential (VLP), P wave dispersion (Pd), QT interval dispersion (QTd), T peak-T end interval and etc.In this paper, the recent research progress on the electrocardiogram changes of OI in children and adolescents is reviewed.
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Bidirectional regulation is one of the key function of acupuncture. The stimulator, mediator and receptor are the basis while the specificity of acupoints and the multi-target regulation of receptors receiving stimulation signals are the essential link of the bidirectional regulation of acupuncture. The possible mechanisms of bidirectional regulation of acupuncture are discussed in 4 aspects, i.e. homeostasis mechanism, stress reaction, central adaptive regulation and autonomic nerve regulation. Knowing the limitations of bidirectional regulation and exploring suitable researchmethods are proposed to be the key points in future researches.
Subject(s)
Acupuncture , Acupuncture Points , Acupuncture TherapyABSTRACT
At Kobe Minato Hot Spring Lotus, a hot spring health promotion facility certified by the Ministry of Health, Labor and Welfare, the effect of subjective evaluation and measurement of blood pressure and autonomic nerves before and after the intervention of the participants. We verified and aimed to build a hot spring utilization type health promotion accommodation type program that can contribute to the physical and mental improvement of participants by short-term accommodation. As a relaxation-based program, basic yoga, underwater exercise, healing yoga, morning yoga, wellness walking, sound healing, bedrock hot yoga, bathing, were carried out. The survey target was recruited after obtaining approval for the use of the “Healthcare Development Citizen Supporter” at the Foundation for Biomedical Research and Innovation at Kobe, and was recruited on 31 women participated in this program (age 53.4±7.3 years old, BMI 22.4±3.4). One week before and one week after the intervention, the Chalder’s fatigue survey was carried out by mail, and blood pressure and autonomic nerves were measured immediately before and immediately after the intervention. The effects were verified from two viewpoints of subjective evaluation and changes in mind and body by measuring autonomic nerves by blood pressure and ccvTP. Before and after the intervention, systolic blood pressure (121.1±13.9 mmHg and 114.6±13.3 mmHg; p＝0.0101) decreased, and diastolic blood pressure (79.0±16.0 mmHg and 72.8±16.6 mmHg; p＝0.0027) also decreased. The overall fatigue (3.07±2.29 and 2.11±2.10; p＝0.0080) of the Chalder’s fatigue survey before and after the intervention was also reduced. No change in autonomic nerves due to ccvTP before and after the intervention was confirmed. In this survey, it was confirmed that Chalder’s fatigue was improved and blood pressure was improved, but the autonomic nerve was not improved. However, since blood pressure has been reported to be related to the autonomic nerves, it may improve the autonomic nerves after long-term stay and after home life, but further investigation is required.
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The difficulty of transanal total mesorectal excision (TME) is to find the correct dissection plane of perirectal space. As a complex new surgical procedure, the fascial anatomic landmarks of transanal approach operation are more likely to be ignored. It is often found that dissection plane is false after the secondary injury occurs during the operation, which results in the damage of pelvic autonomic nerves. Meanwhile, the mesorectum is easily damaged if the dissection plane is too close to the rectum. Thus, the safety of oncologic outcomes could be limited by difficulty achieving adequate TME quality. The promotion and development of the theory of perirectal fascial anatomy provides a new thought for researchers to design a precise approach for transanal endoscopic surgery. Transanal total mesorectal excision based on fascial anatomy offers a solution to identify the transanal anatomic landmarks precisely and achieves pelvic autonomic nerve preservation. In this paper, the authors focus on the surgical experience of transanal total mesorectal excision based on the theory of perirectal fascial anatomy, and discuss the feature of perirectal fascial anatomy dissection and technique of pelvic autonomic nerve preservation during transanal approach operation.
Subject(s)
Humans , Autonomic Pathways/surgery , Proctectomy , Rectal Neoplasms/surgery , Rectum/surgery , Transanal Endoscopic SurgeryABSTRACT
Urinary and sexual dysfunctions due to intraoperative pelvic autonomic nerve injury have become the most common complications of rectal cancer surgery, seriously affecting postoperative quality of life. How to protect the nerve and urogenital function while ensuring radical resection for rectal cancer has become the focus of research. We previously carried out a series of systematic studies on Denonvilliers fascia, an important anatomical structure closely related to protection of pelvic autonomic nerve, and demonstrated the importance of Denonvilliers fascia in preservation of intraoperative pelvic autonomic nerve and protection of postoperative urogenital function from aspects of anatomy, physiology, tissue, operation practice and so on. Meanwhile, based on the interim results of our multicenter randomized controlled study, we confirmed that total mesorectal excision with preservation of Denonvilliers fascia (innovative TME, iTME) could effectively reduce the incidence of postoperative urinary and sexual dysfunctions in male patients with mid-low rectal cancer, without sacrificing oncologic outcome. In this article, combined with our research results, we review the literature on anatomy research progress of Denonvilliers fascia to demonstrate the significance and research prospect of Denonvilliers fascia in the pelvic autonomic nerve preservation surgery for rectal cancer.
Subject(s)
Humans , Male , Autonomic Pathways , Fascia , Multicenter Studies as Topic , Pelvis/surgery , Quality of Life , Randomized Controlled Trials as Topic , Rectal Neoplasms/surgery , Rectum/surgeryABSTRACT
Blast wave can stimulate the sympathetic and parasympathetic nervous system, leading to the changes of autonomic nervous function. It can also damage the hypothalamus and pituitary, and activate the hypothalamic-pituitarytarget gland axis and the locus ceruleus-sympathetic-adrenal medulla axis, resulting in the changes of endocrine level. In addition, it can activate inflammatory cells, synthesize and release different inflammatory mediators, resulting in the changes of inflammatory response. This paper reviews the changes and interactions of autonomic nervous function, endocrine level and inflammatory response in blast wave injury, and further explains the injury mechanism of blase wave, providing references for the treatment of blast wave injury..
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[Purpose] This study is a case report of an acupuncturist's new evaluation index for acupuncture treatment aimed at reducing or eliminating cardiac rehabilitation inhibitory factors in home medical care due to exacerbation of heart failure. [Method] Acupuncture was evaluated by heart rate variability, respiratory sinus arrhythmia, and saturation pulse O2. [Results] In severe heart failure in the evaluation index used in this study, there was no significant change in the autonomic function of the heart before and after acupuncture stimulation.[Discussion] In order for acupuncture to be accepted as a member of team medical care in the future, acupuncturists need to share objective information for multi-professional collaboration.
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Atrial fibrillation (AF) is the most common arrhythmia in clinical work, accounting for about 1/3 of patients in hospital due to arrhythmia. Recently, more and more studies have shown that cardiac autonomic nerve and its remodeling are involved in the occurrence and maintenance of AF, which is one of the important mechanisms of AF. At present, the treatment methods of AF include drug therapy and radiofrequency ablation. As we all know, drug therapy has many limitations. In this paper, the mechanism of sympathetic, parasympathetic nerve and AF and the changes of cardiac autonomic nerve and its remodeling area before and after the occurrence of AF were studied, so as to explore a better treatment method of AF, and then simplify the tedious steps of radiofrequency ablation, reduce the scope of ablation, more accurately locate ectopic trigger point and vulnerable matrix, reduce the intensity of ablation, improve the success rate of operation and obtain good economic benefits.
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Pulmonary artery denervation (PADN) can block local sympathetic nerve of pulmonary artery,reduce the hemedynamic parameters of pulmonary arterial hypertension(PAH),attenuate pulmonary vascular remodeling,right ventricular hypertrophy and fibrosis,thus improving cardiac function.Early basic experiment has determined the position of sympathetic nerve of pulmonary artery in pulmonary endarterium and confirmed the safety and effectiveness of PADN in the animal model of PAH.PADN may play a role by inhibiting execssive activation of the sympathetic nervous system and renin-angiotension-aldosterone system.PADN has been applied to adult clinical research,and has achieved a good clinical effect.On this basis,the possibility of applying PADN to children's PAH is being explored preliminarily.
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Pulmonary artery denervation (PADN) can block local sympathetic nerve of pulmonary artery, reduce the hemodynamic parameters of pulmonary arterial hypertension(PAH), attenuate pulmonary vascular remodeling, right ventricular hypertrophy and fibrosis, thus improving cardiac function.Early basic experiment has determined the position of sympathetic nerve of pulmonary artery in pulmonary endarterium and confirmed the safety and effectiveness of PADN in the animal model of PAH.PADN may play a role by inhibiting execssive activation of the sympathetic nervous system and renin-angiotension-aldosterone system.PADN has been applied to adult clinical research, and has achieved a good clinical effect.On this basis, the possibility of applying PADN to children′s PAH is being explored preliminarily.
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At Kobe Minato Hot Spring Lotus, a hot spring health promotion facility certified by the Ministry of Health, Labor and Welfare, the effect of subjective evaluation and measurement of blood pressure and autonomic nerves before and after the intervention of the participants. We verified and aimed to build a hot spring utilization type health promotion accommodation type program that can contribute to the physical and mental improvement of participants by short-term accommodation. As a relaxation-based program, basic yoga, underwater exercise, healing yoga, morning yoga, wellness walking, sound healing, bedrock hot yoga, bathing, were carried out. The survey target was recruited after obtaining approval for the use of the “Healthcare Development Citizen Supporter” at the Foundation for Biomedical Research and Innovation at Kobe, and was recruited on 31 women participated in this program (age 53.4±7.3 years old, BMI 22.4±3.4). One week before and one week after the intervention, the Chalder’s fatigue survey was carried out by mail, and blood pressure and autonomic nerves were measured immediately before and immediately after the intervention. The effects were verified from two viewpoints of subjective evaluation and changes in mind and body by measuring autonomic nerves by blood pressure and ccvTP. Before and after the intervention, systolic blood pressure (121.1±13.9 mmHg and 114.6±13.3 mmHg; p＝0.0101) decreased, and diastolic blood pressure (79.0±16.0 mmHg and 72.8±16.6 mmHg; p＝0.0027) also decreased. The overall fatigue (3.07±2.29 and 2.11±2.10; p＝0.0080) of the Chalder’s fatigue survey before and after the intervention was also reduced. No change in autonomic nerves due to ccvTP before and after the intervention was confirmed. In this survey, it was confirmed that Chalder’s fatigue was improved and blood pressure was improved, but the autonomic nerve was not improved. However, since blood pressure has been reported to be related to the autonomic nerves, it may improve the autonomic nerves after long-term stay and after home life, but further investigation is required.
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Objective To evaluate the effect of thoracic paravertebral nerve block (TPVB) on postoperative chronic pain in patients undergoing thoracic surgery.Methods One hundred and forty patients of both sexes,aged 25-64 yr,with body mass index of 18-24 kg/m2,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective thoracoscopic radical resection of lung cancer,were divided into 2 groups (n=70 each) using a random number table method:control group (group C) and TPVB group (group P).Two-point (T4,6) TPVB was performed on the affected side under ultrasound guidance before anesthesia induction,and 0.5％ ropivacaine 20 ml was injected into each puncture site in group P.Sufentanil 0.1 μg/kg was intravenously injected at 10 min before the end of operation in group C.Analgesic pump was connected at the end of operation in two groups,and patient-controlled intravenous analgesia was performed with sufentanil.The patients were followed up after operation.Sufentanil 0.1 μg/kgwas intravenously injected when visual analogue scale score ≥4.The total consumption of sufentanil and the number of requirements for rescue analgesia were recorded at 48 h after operation in both groups.The patients were followed up to 2 months by telephone after operation,the occurrence of postoperative chronic pain was recorded,and the effect of pain on daily life and grade of treatment measures were evaluated.Results Compared with group C,the total consumption of sufentanil and the number of requirements for rescue analgesia were significantly reduced,and the impact of postoperative chronic pain on daily life and grade of treatment measures for pain were decreased in group P (P＜0.05).There was no significant difference in the incidence of postoperative chronic pain between the two groups (P＞ 0.05).Conclusion Although TPVB cannot reduce the incidence of postoperative chronic pain,it can relieve the degree of postoperative chronic pain in patients undergoing thoracic surgery.
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Objective@#Using previous total mesorectal excision with pelvic autonomic nerve preservation (PANP+TME) and simple total mesorectal excision (TME) without emphasis on retained nerves as control, we explore the advantages of nerve plane-oriented laparoscopic total mesorectal excision (NPO+LTME) on urinary and sexual function.@*Methods@#A retrospective cohort study was carried out. Case inclusion criteria: (1) male patients with pathologically confirmed middle and low rectal adenocarcinoma (4 to 11 cm from the anus); (2) stage T1-2tumor; (3) normal sexual life before operation. Exclusion criteria: (1) no pathological diagnosis before surgery; (2) local recurrence or distant metastasis; (3) preoperative neoadjuvant chemoradiotherapy; (4) opensurgery and laparoscopic surgery conversionto open; (5) no follow-up data. According to the above criteria, clinical data of 173 male patients with low and middle rectal adenocarcinoma who underwent radical operation for laparoscopic rectal cancer from July 2003 to July 2018 at the Department of Gastrointestinal Surgery, Wuhan University People′s Hospital were collected. According to different surgical methods, patients were divided into TME group (58 cases), PANP+TME group (63 cases) and NPO+LTME group (52 cases). There were no significant differences in the baseline data including age, body mass index and pathological examination between the 3 groups (all P>0.05). The nerve plane referred to the nerve, the adipose tissue, the extremely finecapillaries around the nerve with overlying fine membranous tissue. NPO+LTME referred to the process of laparoscopic TME guided by the nerve plane, performing in the loose connective tissue between the nerve plane and the rectal properfascia, in order to ensure the integrity of the nerve plane, and maximally protect the patient's urinary and reproductive functions. The operation time, intraoperative blood loss, urinary catheter removal time, urinary function grading, postoperative first erection time, and erectile function and ejaculation function were observed and compared among the 3 groups at 3- and 6-month after operation.@*Results@#In the NPO+LTME group, the PANP+TME group and the TME group, the operation time was (181.9±24.5) minutes, (176.7±29.2) minutes and (137.7±16.2) minutes, respectively (F=54.868, P<0.001); the intraoperative blood lost was (6.0±1.4) ml, (6.5±1.8) ml and (12.8±4.6) ml, respectively (F=95.016, P<0.001); the time to postoperative removal of the catheter was (2.4±1.1) days, (3.7 ±1.7) days and (6.5±2.4) days, respectively (F=79.409, P<0.001); the first postoperative erection time was (1.6±0.6) days, (8.9±2.7) days and (15.9±6.8) days (F=177.677, P<0.001), respectively, whose differences were all statistically significant (all P<0.01). In comparison of urinary function grading, the proportion of grade I (normal function, no urinary dysfunction) in the NPO+LTME, the ANP+TME group and the TME group was 84.1% (53/63), 39.7% (23/58) and 19.2% (10/52), respectively, and the difference was statistically significant (H=52.915, P<0.001). At postoperative 3- and 6-month, proportion of patients with grade I erectile function (normal erectile function) was 77.8% (49/63) and 85.7% (54/63), 44.8% (26/58) and 53.4% (31/58), 28.8% (15/52) and 48.1% (25/52) in the NPO+LTME group, the PANP+TME group, and the TME group, respectively. The differences were statistically significant (H=91.709, P<0.001; H=79.692, P<0.001). The proportion of patients with grade I ejaculation function (with ejaculation, no abnormalities in routine semen examination before and after surgery) at 3- and 6-month after surgery in the NPO+LTME group, the PANP+TME group and the TME group was 82.5% (52/63) and 87.3% (55/63), 53.4% (31/58) and 60.3% (35/58), 28.8% (15/52) and 46.1% (24/52), respectively. The differences were statistically significant as well (H=86.543, P<0.001; H=78.667, P<0.001). Patients in the NPO+LTME group had no grade III erections and ejaculation disorders.@*Conclusion@#The surgical procedure of NPO+LTME can promote the recovery of postoperative neurological function and preserve urination and sexual function better.
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Objective To investigate effects of laryngeal mask ventilation combined with continuous nerve block analgesia versus the endotracheal intubation under general anesthesia on postoperative lung infection in elderly patients undergoing orthopedic surgery,so as to provide a theoretical basis for a reasonable anesthesia method.Methods A total of 180 elderly patients undergoing lower extremity orthopedic surgery at our hospital from January 2016 to December 2016 were enrolled and randomly divided into two groups.The control group (n =90) were treated with endotracheal intubation under general anesthesia and intravenous analgesia after the operation,and the observation group (n =90)received the ultrasound-guided continuous nerve block analgesia in spontaneous respiration with laryngeal mask ventilation.The anesthetic dosage,awakening time,visual analogue scale(VAS)scores,and incidence of lung infections at 7 days after surgery were compared between the two groups.Pathogenic strains causing lung infections were isolated and identified.Results The anesthetic dosage was lower in the observation group than in the control group(P ＜ 0.05).The awaking time was shorter in the observation group than in the control group[(22.4±4.4) min vs.(34.1±8.5)min,P ＜0.05].The VAS scores under postoperative exercise were lower in the observation group than in the control group(P ＜0.05).The adverse reaction rate after surgery was lower in the observation group than in control group(3.3％ or 3/90 cases vs.41.1％ or 37/90 cases,P ＜0.05).The incidence of lung infections at 7 days after surgery was lower in the observation group than in the control group(3.3％ or 3/90 cases vs.11.1％ or 10/90 cases,P＜0.05).Ten pathogenic strains were isolated from control group,of which 9 strains were gram-negative bacteria,accounting for 90.0％.Three pathogenic strains were isolated from the observation group,of which 2 strains were gram-negative bacteria,accounting for 66.7％.Conclusions Laryngeal mask ventilation combined with continuous nerve block analgesia can reduce the anesthetic dosage,shorten the awaking time,provide a better analgesic effect and decrease the incidence of lung infections in elderly patients undergoing lower extremity orthopedics.The main pathogenic bacteria are gram-negative bacteria.
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Introducción. El dolor es el principal síntoma que se presenta en el 40% de los pacientes oncológicos en tratamiento y en entre el 80% y el 85% de pacientes con la enfermedad avanzada. Dentro de las herramientas farmacológicas, los opioides son una opción con los consecuentes efectos secundarios, momento en el cual los procedimientos intervencionistas adquieren su importancia. El objetivo del artículo es mostrar el impacto sobre el control del dolor y la calidad de vida en paciente con dolor oncológico abdominal sometido a bloqueo celíaco o hipogástrica en un periodo de 3 meses, con el fin de generar conocimiento del tema en el área de la salud. Metodología. Se realizó una serie descriptiva de casos en un período de 3 meses. Se incluyeron 34 pacientes adultos con dolor abdominal de origen oncológico, con propuesta de bloqueo neurolítico de plexos celíacos o hipogástrico superior como método de control del dolor y se realizó un análisis de las variables en el programa estadístico IBM SPSS Versión 19. Resultados. Se encontró alivio del dolor en el 79.4% de los pacientes intervenidos al poco tiempo del procedimiento y de 33.3% a los 3 meses. No se encontró significante mejoría en la calidad de vida evaluada con el cuestionario SF-36. Conclusiones. Se encontró en este estudio que pacientes con índice de Karnofsky <50 tuvieron alta tasa de mortalidad posterior al bloqueo. La técnica de fenolización más radiofrecuencia podrían tener mejor respuesta terapéutica. Son necesarios más estudios para evaluar posibles asociaciones. Cómo citar. Jaimes J, Leotau MA, Rangel GW, Miranda N, García-Salazar N, Rangel-Vera JA. Efectividad del bloqueo neurolítico simpático abdominal en una serie de casos descriptiva en pacientes con dolor oncológico. MedUNAB. 2019;22(3):330-340. doi: 10.29375/01237047.3337
Introduction. Pain is the main symptom that occurs in 40% of cancer patients undergoing treatment and between 80% and 85% of patients with advanced cancer. Out of the pharmacological tools, opioids are an option with secondary effects, which makes interventional procedures important. The objective of the article is to demonstrate the impact of celiac or hypogastric plexus block in a three-month period on the pain control and quality of life of patients with abdominal oncological pain in order to generate knowledge of this topic in the healthcare sector. Methodology. A descriptive case series was conducted in a three-month period. Thirtyfour adult patients with oncological abdominal pain with proposed celiac or superior hypogastric plexus block as a method of pain control were included and an analysis was conducted of the variables in the statistical program IBM SPSS Version 19. Results. Pain relief was found in 79.4% of the treated patients shortly after the procedure and in 33.3% of the treated patients after 3 months. No significant improvement was evidenced in the quality of life evaluated with the SF-36 questionnaire. Conclussions. The study found that patients with a Karnofsky performance score of < 50 had a high mortality rate after the block. The technique of phenolization and radiofrequency could have a better therapeutic response. More studies are needed to assess possible associations. Cómo citar. Jaimes J, Leotau MA, Rangel GW, Miranda N, García-Salazar N, Rangel-Vera JA. Efectividad del bloqueo neurolítico simpático abdominal en una serie de casos descriptiva en pacientes con dolor oncológico. MedUNAB. 2019;22(3):330-340. doi: 10.29375/01237047.3337
Introdução. A dor é o principal sintoma que ocorre em 40% dos pacientes oncológicos em tratamento e entre 80% e 85% dos pacientes com a doença avançada. Dentro das ferramentas farmacológicas, os opióides são uma opção com consequentes efeitos colaterais, momento em que os procedimentos intervencionistas se tornam importantes. Objetivo. O objetivo do artigo é mostrar o impacto no controle da dor e na qualidade de vida em pacientes com dor oncológica abdominal submetido a bloqueio celíaco ou do plexo hipogástrico em um período de 3 meses, a fim de gerar conhecimento sobre o assunto na área da saúde. Métodos. Foi feita uma série descritiva de casos durante um período de 3 meses. Foram incluídos 34 pacientes adultos com dor abdominal de origem oncológica, com proposta de bloqueio neurolítico do plexo celíaco ou hipogástrico superior como método de controle da dor e a análise das variáveis foi realizada no programa SPSS statistic 19 IBM. Resultados. Observou-se alívio da dor em 79.4% dos pacientes operados logo após o procedimento e em 33.3% 3 meses depois. Não houve melhora significativa na qualidade de vida avaliada com o questionário SF-36. Discussão. Encontrou-se neste estudo que pacientes com índice de Karnofsky > 50 apresentaram alta taxa de mortalidade após o bloqueio. A técnica de fenolização e a radiofrequência poderiam ter melhor resposta terapêutica. Mais estudos são necessários para avaliar possíveis associações. Cómo citar. Jaimes J, Leotau MA, Rangel GW, Miranda N, García-Salazar N, Rangel-Vera JA. Efectividad del bloqueo neurolítico simpático abdominal en una serie de casos descriptiva en pacientes con dolor oncológico. MedUNAB. 2019;22(3):330-340. doi: 10.29375/01237047.3337