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Effects of stellate ganglionic block on hemodynamic changes and intrapulmonary shunt in perioperative patients with esophageal cancer . OBJECTIVE The aim of this study was to observe the effects of stellate ganglion block ( SGB ) on hemodynamic changes and intrapulmonary shunt during one-lung ventilation ( OLV ) . PATIENTS AND METHODS Thirty ASA class I-II patients undergoing elective esophageal surgery were randomly divided into two groups : general anesthesia group ( group N , n=15 ) and general anesthesia combined SGB group ( group S , n=15 ) , patients in group S were received left SGB before induction . Radial artery was cannulated for arterial blood pressure ( ABP ) monitoring and blood sampling and Swan-Ganz catheter was position in the pulmonary artery via right internal jugular vein under local anesthesia . ECG , MAP , HR , CVP , continuous cardiac output ( CCO ) index and BIS were continuously monitored during anesthesia . General anesthesia was induced with propofol 1.5-2.0 mg/kg , sufentanil 0.4 μg/kg , and Rocuronium 0.6-0.9 mg/kg . Endobronchial occluder was placed blindly after tracheal indubation and the correct position was verified by auscultation and fiberoptic bronchoscopy . The patients were mechanically ventilated . The ventilation conditions were Fio2=100 % , VT = 8-10 ml/kg , I : E = 1:2 and respiratory rate was adjusted to maintained PETCO2 at 35-45 mmHg during both two-lung ventilation ( TLV ) and OLV . Anesthesia was maintained with continuous infusion of propofol 4-10 mg/kg·h , sufentanil 0.2 μg/kg·h , vecuronium o.1 mg/kg·h , BIS was maintained at 45-55 . Blood samples were taken from radial artery and S-G catheter for blood gas analysis at following intervals : during spontaneous breathing when the patient was awake ( T0 ) , 1 min after tracheal indubation ( T1 ) , 1 min after patient was placed in lateral position ( T2 ) and 15 min after it ( T3 ) , 1 min after ribs was braced ( T4 ) , 30 , 60 , 120 min during the course of OLV ( T5 , T6 , T7 ) , the two lungs were ventilated again for 30 min ( T8 ) and Qs/Qt was calculated . RESULTS SVRI , MAP , HR in group N increased significantly at T1 , T2 , T4 compared with group S ( p < 0.05 ) . Qs/Qt was significantly increased after patient was placed in lateral position and increased further during OLV ; the calculated Qs/Qt values were highest at T5· PaO2 was significantly lower after OLV was started and reached the lowest level at T6 then was gradually increasing . There was no significant difference in Qs/Qt and PaO2 at all time points between two groups . CONCLUSIONS SGB before induction effectively suppress the stress response work as stable blood dynamics and does not affect Qs/Qt and arterial oxygenation during OLV , SGB is a safe technique of anesthesia for general thoracic surgery .
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Intervention_Physical
stellate ganglionic block
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Outcome_Physical
hemodynamic changes
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Outcome_Physical
intrapulmonary shunt
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Outcome_Physical
hemodynamic changes
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Outcome_Physical
intrapulmonary shunt
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Outcome_Physical
arterial blood pressure ( ABP ) monitoring and blood
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Participant_Condition
perioperative patients with esophageal cancer
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Participant_Condition
METHODS
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Participant_Condition
ASA class I-II patients undergoing elective esophageal surgery