Ultrasound-guided stellate ganglion block accelerates postoperative gastrointestinal function recovery following laparoscopic radical gastrectomy for gastric cancer / 南方医科大学学报

ABSTRACT

OBJECTIVE@#To explore the effects of ultrasound-guided stellate ganglion block (SGB) on perioperative stress response, gastrointestinal hormones and postoperative gastrointestinal function recovery in patients undergoing laparoscopic radical gastrectomy for gastric cancer.@*METHODS@#This study was conducted among 60 American Society of Anesthesiologists (ASA) class II-III patients with gastric cancer (regardless of gender, aged 35-75 years with BMI of 18.5-26 kg/m2) undergoing elective laparoscopic radical gastrectomy. The patients were randomized into experimental group (S group, n=30) and control group (NS group, n=30). In S group, SGB at the C6 level of the right cervical spine was performed under ultrasound guidance 15 min before induction of anesthesia by injection of 7 mL 0.5% ropivacaine; the patients in NS group received injections of normal saline in the same manner. Peripheral venous blood samples were collected before SGB (T1), after surgery (T2), and on the 2nd and 6th days after surgery (T3 and T4) for determination of the levels of motitin (MOT), vasoactive intestinal peptide (VIP), cortisol (COR), and blood glucose (GLU). Intraoperative usage of sufentanil, recovery rate of intestinal sounds at 36, 48, 60, 72, 84 and 96 h after operation and the time of first passage of flatus were recorded and compared between the two groups.@*RESULTS@#There was no significant difference in the total amount of sufentanil consumption between the two groups. Compared with those in NS group, the patients in S group had significant lower COR and VIP levels (P < 0.05) and higher MOT level (P < 0.05) at T2, T3 and T4. Glu level at T2 and T3 was also significantly lower in S group (P < 0.05). The recovery rates of intestinal sounds at 36, 48, 60, 72 and 84 h after surgery were significantly higher (P < 0.05) and the time of the first passage of flatus was earlier in S group than in NS group (P < 0.05).@*CONCLUSION@#In patients with gastric cancer undergoing laparoscopic radical gastrectomy, ultrasound-guided SGB can reduce postoperative stress level, promote the recovery of gastrointestinal hormone secretion, and accelerate postoperative recovery of gastrointestinal functions.