ABSTRACT
STUDY OBJECTIVE: Elderly patients undergoing elective laparoscopic cholecystectomy (LC) were given right stellate ganglion block (RSGB) to observe its effects on the hemodynamics and stress response during carbon dioxide (CO2)-pneumoperitoneum. DESIGN: A randomized, single-blinded, and placebo-controlled study. SETTING: University-affiliated teaching hospital. PARTICIPANTS: Sixty patients (aged 65-78years; weight, 45-75kg; American Society of Anesthesiologists (ASA) physical status classification, class I or II) undergoing elective LC. INTERVENTIONS: Right stellate ganglion block was performed via C7 access using 10mL of 1% lidocaine in all patients. MEASUREMENTS: The patients' heart rate (HR) and mean arterial pressure (MAP) were recorded before the block (T0), 5min following pneumoperitoneum (T1), 30min following pneumoperitoneum (T2), 5min following the deflation of pneumoperitoneum (T3), and upon completion of the surgery (T4). Additionally, the concentrations of epinephrine (E), norepinephrine (NE) and cortisol (COR) were detected in arterial blood at each time point by enzyme-linked immunosorbent assay. MAIN RESULTS: For control group, the MAP and RPP (RPP=SBP×HR) were significantly elevated at T1~3 (P<0.05) as compared to T0. Inter-group comparison showed that the MAP, HR and RPP were significantly lower at T1~4 in RSGB group (P<0.05 or 0.01). As compared to T0, the E, NE and COR levels significantly rose at T1~4 in control group (P<0.05 or 0.01) and COR at T2, 3 in RSGB group (P<0.05). The E, NE and COR levels at T1~4 were significantly lower in RSGB group as compared to control group (P<0.05 or 0.01). CONCLUSION: Right stellate ganglion block can reduce blood catecholamines during CO2-pneumoperitoneum to maintain perioperative hemodynamic stability and prevent adverse cardiovascular events in elderly patients.
