Impacts Of Ultrasound-guided Stellate Ganglion Block On Perioperative Inflammation And Postoperative Gastrointestinal Function Recovery In Patients Undergoing Gastrointestinal Surgery

Background:The aim of this study was to explore the effects of unilateral stellate ganglion block(SGB)on inflammatory response and gastrointestinal function recovery after gastrointestinal surgery.Methods:patients undergoing gastrointestinal surgery were enrolled,and then randomly divided into SGB group and control group by the ratio of 1:2.The final statistical results were obtained from 18 patients and 42 patients in SGB group and control group,respectively.In SGB group,ultrasound-guided SGB was conducted with 7ml of 0.5%ropivacaine at the C6 level.The same procedures were performed for the control group except that normal saline was injected instead of ropaivacaine.Blood samples,used for serum tumor necrosis factor(TNF)-?,interleukin(IL)-1? and IL-6 measurements,were collected for both groups at Oh(before injection)and 2h,4h,24h after the SGB.We also collected the clinical level of leukocytes,platelets,bilirubin and creatinine before and at the first day after SGB.The bowel sounds recovery time and the anal or stoma exhaust time after the surgery were also recorded.Results:The concentrations of TNF-a at the 2hr and 4hr and the IL-1? at the 2hr and 24hr were significantly lower than those in the control group(with P values less than 0.05).The IL-6 levels between the two groups had indistinguishable difference.The amount of leukocytes at the first day after surgery was increased by 4.05±4.03×109/L in the SGB group,whichwaslower than that in control group whose increment was 6.37±3.35×109/L.But there was no difference between the two groups in the levels of platelets,bilirubin and creatinine one day after SGB.As for the gastrointestinal function recovery after surgery,there were differences between the two groups both in the bowel sounds recovery time(SGB group 46.22±31.02 hours VS control group 72.27±35.70 hours,P<0.05)and the anal or stoma exhaust time(SGB group 65.78±33.93 hours VS control group 94.40±43.38 hours,P<0.05).Conclusion:For patients undergoing gastrointestinal surgery,SGB can inhibit the cytokines like TNF-a and IL-1?,and lowered the increment of leukocytes.SGB can also shorten the bowel sounds recovery time and the anal or stoma exhaust time after surgery.These indicate that SGB may regulate the perioperative inflammatory response and promote the recovery of gastrointestinal function.