| ObjectiveTo evaluate the effect of ultrasound-guided stellate ganglion block(SGB)on rapid recovery after laparoscopic partial hepatectomy.MethodsA total of 58 patients undergoing elective laparoscopic partial hepatectomy in Shaoxing People’s Hospital from January 2021 to July 2022 were selected and included in the experimental group(group S with 0.5% ropivacaine planetary ganglion block,30 cases)and the control group(group N with normal saline planetary ganglion block,28 cases).The serum inflammatory cytokines IL-2,IL-6,IL-10,TNF-α and IFN-γ were detected by Cytometric Bead Array(CBA).Main outcome: Serum inflammatory factor levels were compared between the two groups before SGB(T0),1 hour after surgery(T1),3 hours after surgery(T2),6 hours after surgery(T3),24 hours after surgery(T4),and 72 hours after surgery(T5).Secondary outcome: Complications 30 days after surgery,intraoperative and postoperative related events,perioperative hemodynamics,postoperative liver function,postoperative hospital stay and other differences between the two groups were observed.This study has been registered at Clinial Trials.gov,NCT05587023,and is ongoing.ResultsThe main results: The fluctuation of IL-6 and IL-10 in group S was smaller than that in group N at each observation time point.At T3 and T4,IL-6 in both groups reached the relative peak,and group S [62.82(26.81,173.19),62.37(33.5,117.62)] was lower than group N[153(82.88,610.11),175.95(74.05,354.83),P < 0.01].At T5,IL-6 level in group S [26.57(11.36,55.21)] had no significant difference compared with that at T0 before block [4.67(2.9,9.66)](P=0.652),while IL-6 level in group N [43.99(20.16,77.87)] had significant difference compared with that at T0 before block [5.54(3.06,7.53)](P < 0.001).At T5,the level of IL-10 in group S [3.36(2.24,7.73)] was not significantly different from that at T0 before block [2.89(1.36,5.46)](P=0.115).In group N were still different(P=0.002).Secondary outcomes: The number of patients requiring vasoactive drug intervention was significantly lower in group S [14(43.3%)] than in group N [20(71.4%)](P=0.031).At the same time,in the fluctuation of MAP,the variance of the S group(F= 19.443)was smaller than that of the N group(F= 24.318),the dispersion of the data was smaller,and the fluctuation of blood pressure was smaller.The length of hospital stay in group S was less than that in group N(8.2±2.1,10.2±3.8,P=0.02),and the hospitalization cost in group S was less than that in group N(30029.60(24493.24,37515.19),38622.35(31676.04,44861.15),P= 0.015).The length of hospital stay was moderately and significantly correlated with the concentration of IL-6 at T4(r= 0.3917;P= 0.0024;n= 58).Hospitalization costs(calculated from the day of surgery)were moderately and significantly correlated with IL-6 concentration at T4(r= 0.4170;P= 0.0011;n= 58).ConclusionUltrasound-guided SGB has a positive effect on the rapid recovery of patients after laparoscopic partial hepatectomy.It can make the inflammatory cytokines more stable,the perioperative hemodynamics more stable,and reduce the length of hospital stay and hospitalization costs. |
PDF Full Text Request