Effect Of SGB On Serum Inflammatory Factors And Postoperation Cognitive Function

Objective: To explore the impacts of Stellate ganglion block(SGB)on serum inflammatory factors,NSE,S100-β protein in patients who undergoing cardiac valve replacement during cardiopulmonary bypass and the therapeutic effect on the postoperative cognitive function.Methods: Selected forty cases patients from The First Affiliated Hospital of Guangxi Medical University,underwent cardiac valve replacement during cardiopulmonary bypass(CPB).No gender,aged 25 to 55 yeas of age.And had preoperative heat function class(NYHA)Ⅱ or Ⅲ and ASA Ⅱ or Ⅲ.These patients were randomized into SGB group(S group,with Stellate ganglion block,n=20)and control group(N group,without SGB,n=20).S group was treated with right side SGB under the guidance of ultrasonic diagnostic instrument,when the patient developed the same siade of the ptosis,eyeball invagination and other Honer syndrome,the ganglion block was considered to be successful.After 15 min,anesthesia was induced directly according to routine anesthesia,and no block was found in group N,and the anesthesia regimen was induced in the same as group S.Respectively obtain 5 ml cervical venous blood by test tube at the following 6 time points:after anesthesia induced intubation(T1),after the completion of the first infusion of cardioplegia was performed after 15 min(T2),extracorporeal circulation end immediately(T3),1 hour after extracorporeal circulation(T4),6 hours after cardiac surgery(T5),and 24 hours after cardiac surgery(T6).The serum levels of interleukin-6(IL-6)、Concentrations of interleukin-10(IL-10)、neuron-specific enolase(NSE)and neurotissue protein(S100β protein)were measured by enzyme-linked immunosorbent assay(Elisa).The cognitive function of all patients at the first day before cardiac surgery,the first day after cardiac surgery and the fifth day after cardiac surgery were scoreded by Mini-Mental State Examination(MMSE).Results: At T1 time point,the concentration levels of serum IL-6,IL-10,NSE and S100 β protein was no statiscally remarkably difference between the two groups(P>0.05).The concentration levels of serum IL-6,IL-10,NSE and S100 β concentrations at each time point from T2 to T6 in the both groups were remarkably greater than those at T1 time point(P<0.05).The concentration levels of serum NSE,S100 β protein and IL-6 in group S were remarkably lower than those at group N at these five time points from T2 to T6,while the concentration of IL-10 in group S was remarkably greater than that of N group was statistically significant(P<0.05).On the first day before surgery and the fifth day after surgery,the two groups have no obviously difference in the MMSE grades(P>0.05).But the grades of the first day after surgery was less than the first day before surgery in group S and group N(P<0.05),and the group S,grades was obviously above group N,the difference of the two set date was extremely significant(P<0.05).Conclusion: SGB can relieve the degree of inflammatory mediators remarkably in patients with extracorporeal circulation cardiac valve replacement surgical procedures,alleviate the brain injury,suppress the express degree of S100 β protein and NSE in serum during CPB,and have certain brain protection function.