Effects of ultrasound-guided right stellate ganglion block on postoperative visceral pain, nausea and vomiting in patients undergoing laparoscopic cholecystectomy

doi:10.11958/20220866

Abstract

Abstract:

Objective To investigate the effect of ultrasound-guided right stellate ganglion block (SBG) on postoperative visceral pain and postoperative nausea and vomiting (PONV) in patients undergoing laparoscopic cholecystectomy (LC). Methods A total of 120 patients scheduled for elective LC were divided into the SGB group (n=60) and the control group (n=60) using a random number table. Ultrasound-guided right SGB was conducted with 1% lidocaine 6 mL before surgery in the SGB group, and the equal volume of normal saline was given at the same site in the control group. Local infiltration anesthesia at incision site was performed with 1% ropivacaine 10 mL at the end of surgery in both groups. The mean arterial pressure (MAP) and heart rate (HR) were recorded at different time points, including before anesthesia induction (T₀), after endotracheal intubation (T₁), skin incision (T₂), pneumoperitoneum establishment (T₃), 10 min after pneumoperitoneum establishment (T₄) and at the end of surgery (T₅). Postoperative visceral pain scores evaluated by the Numerical Rating Scale (NRS) at four times (0.5 h, 4 h, 12 h, 24 h after surgery), incidence of PONV and rate of using antiemetics during the first 24 h after surgery were recorded. The operation time, total dose of propofol and remifentanil, extubation time, first anal exhaust time, Athens Insomnia Scale (AIS) scores on the first night after surgery and satisfaction scores were recorded as well. Results The MAP and HR were significantly lower at T₁ and T₄ in the SGB group than those in the control group (P<0.05). Compared with the control group, the SGB group showed lower NRS scores of visceral pain at 4 h and 12 h after surgery, lower incidence of PONV and lower rate of using antiemetics (P<0.05). Meanwhile, earlier first anal exhaust, lower AIS scores on the first night after surgery and higher satisfaction scores were observed in the SGB group (P<0.05). Conclusion Ultrasound-guided right SGB can alleviate postoperative visceral pain in patients after LC, reduce the incidence of PONV and improve the quality of sleep after surgery.

Key words: stellate ganglion, cholecystectomy, laparoscopic, visceral pain, postoperative nausea and vomiting

CLC Number:

R614.4

Figures/Tables 6

References 17

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组别	性别（男/女）	年龄（岁）	体质量（kg）	手术时间（min）	丙泊酚用量（mg）	瑞芬太尼用量（μg）
对照组	28/32	45.2±11.3	66.2±8.1	54.5±20.9	268.8±77.7	1 095.1±386.9
SGB组	31/29	44.9±11.4	65.5±8.4	57.1±21.0	257.3±74.9	1 063.1±357.2
χ²或t	0.300	0.121	0.454	0.680	0.824	0.471

组别	性别（男/女）	年龄（岁）	体质量（kg）	手术时间（min）	丙泊酚用量（mg）	瑞芬太尼用量（μg）
对照组	28/32	45.2±11.3	66.2±8.1	54.5±20.9	268.8±77.7	1 095.1±386.9
SGB组	31/29	44.9±11.4	65.5±8.4	57.1±21.0	257.3±74.9	1 063.1±357.2
χ²或t	0.300	0.121	0.454	0.680	0.824	0.471

组别	MAP（mmHg）						HR（次/min）
组别	T₀	T₁	T₂	T₃	T₄	T₅	T₀	T₁	T₂	T₃	T₄	T₅
对照组	94.6±9.1	97.3±13.9	78.1±13.3^a	87.7±13.3^a	87.7±11.8^a	83.3±10.8^a	77.3±10.4	84.7±12.9^a	64.3±9.0^a	69.2±10.1^a	72.5±10.1^a	70.6±9.9^a
SGB组	95.8±8.6	90.8±13.7^a	79.5±12.1^a	88.0±12.7^a	82.1±11.1^a	81.6±10.5^a	77.9±10.0	79.2±12.0	66.4±10.0^a	70.8±11.7^a	68.8±10.1^a	68.0±8.3^a
t	0.773	2.550^＊	0.590	0.126	2.659^＊＊	0.830	0.277	2.427^＊	1.193	0.802	1.985^＊	1.538

组别	MAP（mmHg）						HR（次/min）
组别	T₀	T₁	T₂	T₃	T₄	T₅	T₀	T₁	T₂	T₃	T₄	T₅
对照组	94.6±9.1	97.3±13.9	78.1±13.3^a	87.7±13.3^a	87.7±11.8^a	83.3±10.8^a	77.3±10.4	84.7±12.9^a	64.3±9.0^a	69.2±10.1^a	72.5±10.1^a	70.6±9.9^a
SGB组	95.8±8.6	90.8±13.7^a	79.5±12.1^a	88.0±12.7^a	82.1±11.1^a	81.6±10.5^a	77.9±10.0	79.2±12.0	66.4±10.0^a	70.8±11.7^a	68.8±10.1^a	68.0±8.3^a
t	0.773	2.550^＊	0.590	0.126	2.659^＊＊	0.830	0.277	2.427^＊	1.193	0.802	1.985^＊	1.538

组别	NRS评分（分）				补救镇痛
组别	术后0.5 h	术后4 h	术后12 h	术后24 h	补救镇痛
对照组	3.0（2.0，3.0）	3.0（2.0，3.8）	2.0（2.0，3.0）	2.0（1.0，2.0）	11（18.3）
SGB组	3.0（2.0，3.0）	2.0（2.0，3.0）	2.0（1.0，2.0）	2.0（1.0，2.0）	13（21.7）
Z或χ²	0.076	1.978^＊	2.398^＊	1.501	0.208