| Objective This study aimed to investigate the effect of preoperative ultrasound-guided stellate ganglion block(SGB)on perioperative stress response and gastrointestinal function in patients undergoing laparoscopic colorectal cancer surgery and to provide a new clinical approach to promote postoperative recovery in patients with colorectal cancer.Methods This study is a prospective randomized controlled blind trial.From April2020 to December 2020,60 patients with laparoscopic radical resection of colorectal cancer under general anesthesia were selected as the subjects.The random number method was used and it was divided into two groups.One is SGB group that immediately before anesthesia induction,0.5% ropivacaine 7m L was injected into the right stellate ganglion under ultrasound guidance.Another one is control group: routine general anesthesia was not accepted for stellate ganglion obstruction.Recording data before(T1),30 minutes after pneumoperitoneum(T2),2hours after pneumoperitoneum(T3),30 minutes after extubation(T4),24 hours after operation(T5),48 hours after operation(T6)at each time point,The heart rate(HR)and mean arterial pressure(MAP)were recorded in the two groups at five T1、T2、T3 、 T4 、 T5 time points.Stress indicators: epinephrine,cortisol,endothelin-1:peripheral blood was collected for 5ml.at T1、T4、T5 three time points.Blood samples were centrifuged at 3000 rpm min for 5 min,Collect supernatant-80℃refrigerator to store;Gastrointestinal hormone motilin and vasoactive intestinal peptide detection: peripheral blood was collected for 5 ml.at T1、T5、T6 three time points.Blood samples were centrifuged at 3000 rpm min for 5 min,remove supernatant-80℃ refrigerator for storage.Evaluate and record postoperative bowel sound recovery time and first anal / ostomy exhaust time.Results There were 26 cases in SGB group and 26 cases in control group.In general data,there was no significant difference between the two groups(P>0.05).From the aspects of Hemodynamic,the differences were not statistically between the two groups in MAP and HR(P>0.05),but there were statistically significant differences within the group(P < 0.05),and no interaction between grouping and time(P>0.05).Gastrointestinal function,The recovery time of bowel sounds in SGB group and control group(45.36±30.12 hours in SGB group and 68.53±34.71 hours in control group,P=0.032)and first exhaust time(63.24±31.02 hours in SGB group VS 91.24 and 40.03 hours in control group,P=0.041)had significant statistical differences,and motilin(T5 P=0.001,T6 P=0.014 and VIP(T5 P=0.013,T6 P=0.003)the level difference was statistically significant.Finally,about the perioperative stress response,SGB group showed postoperative epinephrine(T4P=0.011,T5 P=0.008,cortisol(T4 P=0.001,T5 P=0.006,endothelin-1(T4 P=0.00,T5 P=0.000)levels were lower than those in the control group.Conclusion SGB can reduce the concentration of epinephrine,cortisol and endothelin-1 peripheral blood.Not only increase the level of motilin and decrease the level of VIP,but also shorten the time of recovery and first exhaust of bowel sounds after operation.It is suggested that unilateral stellate ganglion block guided by ultrasound can reduce gastrointestinal dysfunction and stress response after laparoscopic radical resection of colorectal cancer and then promote the recovery of gastrointestinal function. |
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