Impacts Of Ultrasound-guided Stellate Ganglion Block On Early Postoperative Quality Of Recovery In Patients Undergoing Laparoscopic Surgery

Objective:To study that preoperative stellate ganglion block affects on the quality of early recovery after laparoscopic surgery.Methods:60 patients with line elective laparoscopic hysterectomy,BMI 18.5～26 kg/m~2,aged 40～65,ASAⅠorⅡ,randomly fall into two sets(n=30):SGB Joint General Anesthesia(S)and Simple General Anesthesia(C).One case in group C was excluded due to intraoperative conversion to open abdomen.Group S was given RSGB and 0.2%ropivacaine 4ml as the blocking drug 15 minutes before anesthesia induction.Group C was not given special treatment.During the perianesthesia period,two groups were given intravenous anesthesia.We used QOR-40 to assess the restore quality of 1 day before surgery and 24h after surgery.Perioperative hemodynamic fluctuations were recorded.The serum glucose concentration of the two groups was measured at four time points at entry,30min after skin resection,extubation and the first postoperative day.Anal exhaust,gastrointestinal flatulence,shoulder tip pain,nausea and vomiting were followed up.Results:In the QOR-40 score 24 hours after surgery,the total score of S group showed obvious superiority[the total score of S group189.00(188.00-190.00)was significantly higher than that of C group185.00(182.00-187.00),P<0.01].In the five items of the scale,group S showed prominent advantage in terms of physical comfort and emotional state in contrast to group C(P<0.01),and we found that the pain score of group S was superior to group C(P<0.05),we also found that there was no significant differences in self-care ability and psychological support between the two groups(P>0.05).In terms of perioperative stress response monitoring,we found that two sets of patients with 30 minutes after cut the skin,extubation and postoperative 1 day of GLU were remarkably increased contrast to preoperative(P<0.05),but we also found that the GLU level of group S was below that of group C during the operation and 1 day after the operation(P<0.05).In terms of postoperative recovery,gastrointestinal recovery was observed in S(postoperative exhaust time in S was 20.89±3.08h compared with 15.87±2.98h in C,P<0.05;S 21.33%compared to C 51.72%incidence of abdominal distension,P<0.05),postoperative complications related to cavity mirror(group C 41.36%incidence of postoperative nausea6.67%contrast S group;S 13.33%incidence of postoperative shoulder pain compared to C 55.17%;No vomiting occurred in S compared with C17.24%;P<0.05)showed obvious advantages.In addition,no complications associated with nerve block were observed in group S.Conclusion:We found that preoperative stellate ganglion block can improve the quality of early postoperative recovery,reduce the degree of stress response,promote gastrointestinal peristalsis,reduce shoulder tip pain,nausea and vomiting,and have a good help in patients undergoing laparoscopic surgery.