The Effect Of Postoperative Stellate Ganglion Block On Myocardial Injury In Patients Undergoing Laparoscopic Radical Resection Of Colorectal Cancer

Objective:To investigate the effect of stellate ganglion block on postoperative myocardial injury for patients undergoing laparoscopic radical colorectal resection with high-risk factors after emergence from general anesthesia.Methods:Patients who underwent elective laparoscopic radical colorectal resection surgery at China-Japan Union Hospital of Jilin University from October 2021 to June 2022 were included and randomly divided into group C(control group)and group S(block group).Both groups were sent to the post-anesthesia recovery room(PACU)after emergency from general anesthesia,patients in group S were injected with 0.2% ropivacaine of 4 ml with ultra-sound guidance to perform stellate ganglion block,and patients in group C was injected with 0.9% saline of 4 ml around stellate ganglion.Serum troponin concentrations were monitored on postoperative days 1 and 2.The visual analogue score(VAS)pain scores of patients in quiet and deep breathing states on postoperative day 1,Richards Campbell Sleep Quality(RCSQ)on the first postoperative night,time of first flatus,Quality Of Recovery 15(QOR15)on the third postoperative day,and length of hospital stay were recorded.We will record whether the patient develops Horner’s syndrome after the block.The occurrence of block-related adverse events such as hoarseness,puncture site infection,neurovascular injury,local anesthetic intoxication,and postoperative hypotension was also recorded.Results:A total of 235 patients were included in this study,of which 12 patients had their surgery cancelled,12 patients’ families refused to be enrolled,7 patients’ clinicians refused to be enrolled,and 5 patients’ surgeons withdrew from this study due to intraoperative changes in the surgical approach,resulting in the inclusion of a total of 199 patients,100 in Group C and 99 in Group S.There was no significant difference in the baseline information between the two groups.the incidence of MINS was 12.0% and 4.0% in group C and group S,respectively,the difference was statistically significant(p < 0.05).The VAS pain score on postoperative day 1 was0.5 [0.0,2.0] in group C and 0.0 [0.0,2.0] in group S in the quiet state,and the difference was not statistically significant(P > 0.05);it was 4.0 [2.0,4.5] in group C and 3.0 [1.6,4.5] in group S during deep breathing,and the difference was statistically significant(P < 0.05).The RCSQ sleep score on the first postoperative night was 53.0[40.0,63.0] in group C,and 60.0[47.0,78.0] in group S,with statistically significant differences(P < 0.05).There were no significant difference regarding to the time to first flatus,QOR15 scores on the third postoperative day,length of hospital stay and incidence of adverse events between the two groups.(P >0.05).Conclusion:Postoperative stellate ganglion block reduces the incidence of postoperative myocardial injury in patients undergoing laparoscopic radical colorectal cancer surgery,decreases pain scores during deep breathing after surgery,and also improves patients’ postoperative sleep quality.