The Effects Of Stellate Ganglion Block On The Heart Rate Variability And Cognitive Function In Patients With Anxiety Disorder

Objective: To explore the effects of stellate ganglion block(SGB)on clinical symptoms,heart rate variability and cognitive function in patients with anxiety disorder,and to provide evidence for SGB in the treatment of anxiety disorder.Methods: A total of 52 patients with anxiety disorder hospitalized in Sichuan Psychiatric Center of Sichuan Provincial People’s Hospital from January 2022 to January 2023 were included in this research,including 26 in experimental group and 26 in control group.Within 24 hours after admission,self-made general questionnaire,Physical Activity Rating Scale-3(PARS-3),Hamilton Anxiety Scale(HAMA),Hamilton Depression Scale(HAMD),Beck Anxiety Inventory(BAI),Beck Depression Inventory(BDI),Insomnia Severity Index(ISI),heart rate variability(HRV)under resting,tasking and recovery period,Cambridge Neuropsychological Automated Test Battery(CANTAB)were all measured.Both groups were given individualized routine psychiatric treatment,while the experimental group was given 5 times of ultrasound-guided SGB treatment.All patients were assessed with HAMA,HAMD,BAI,BDI,ISI,Treatment Emergent Symptom Scale(TESS),HRV and CANTAB within 24 hours before discharge.SPSS 26.0 software was used to analyze the data.The differences of clinical symptoms,HRV and cognitive function between the two groups were compared at admission and before discharge.Results: 1.Before intervention,there was no significant difference between the two groups in questionnaires,HRV or CANTAB(P>0.05);2.The results of the total score of HAMA,HAMA mental anxiety,HAMA somatic anxiety,HAMD,BAI,BDI or ISI scale of the two groups after intervention were significantly lower than those before intervention(P<0.05);3.After intervention,the score of HAMA somatic anxiety in the experimental group was significantly lower than that in the control group(P<0.05),and the improvement in the symptoms of muscle system,sensory system,cardiovascular system and autonomic nervous system was more significant than that in the control group(P<0.05);4.After the intervention,the SDNN and TP at resting state of the experimental group were higher than those in the control group,and the difference was statistically significant(P<0.05);There was no statistical difference between the two groups in other HRV indicators(P>0.05);5.About the CANTAB test,DMSPEGE in the experimental group was lower than that in the control group,and the difference was statistically significant(P<0.05);There was no statistical difference between the two groups in other cognitive function indicators(P>0.05);6.In the experimental group,there was no significant correlation between the improvement of somatic anxiety and cognitive function with the change of heart rate variability(P>0.05).Conclusion: 1.As an adjunctive therapy,ultrasound-guided SGB can effectively improve the somatic anxiety of patients with anxiety disorder in a short time.2.SGB can regulate the autonomic nervous function of patients with anxiety disorders,which can be monitored by HRV.The results showed that SDNN,TP and LF under natural state increased,LF response score decreased and LF recovery score increased.3.SGB can improve the cognitive function of patients with anxiety disorder,which was manifested by the improvement of visual delay memory and working memory.