超声引导下星状神经节阻滞对局部脑氧饱和度及血流动力学的影响  

Effects of ultrasound-guided stellate ganglion block on hemodynamics and regional cerebral oxygen saturation

作　　者：陈雪杰 王艳红[1] 马艳丽[1] 王涛[2] 马乐天 Chen Xuejie;Wang Yanhong;Ma Yanli;Wang Tao;Ma Letian(Department of Anesthesiology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Department of Pain,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院麻醉科,郑州450052 [2]郑州大学第一附属医院疼痛科,郑州450052

出　　处：《河南外科学杂志》2019年第6期5-8,共4页Henan Journal of Surgery

摘　　要：目的观察超声引导下星状神经节阻滞(stellate ganglion block,SGB)对患者双侧局部脑氧饱和度(rSO2)及血流动力学的影响,为SGB是否改善脑氧代谢及是否有围术期脑保护作用等研究提供参考。方法选择郑州大学第一附属医院疼痛科2018-06—10间收治的45例头、面部疼痛或躯体形式疼痛障碍患者,均接受超声引导下单侧SGB(颈6水平注射0.2%盐酸罗哌卡因4 mL)。利用近红外光谱局部脑氧饱和度监测仪观察SGB前(T 0)及SGB后5 min(T1)、10 min(T2)、15 min(T3)、20 min(T4)、25 min(T5)、30 min(T6)的阻滞侧rSO2(b-rSO2)与非阻滞侧的rSO2(nb-rSO2)。记录患者上述时间点的SBP、DBP、MAP、HR、SpO2。结果T1~6的b-rSO2较T 0均升高,差异有统计学意义(P<0.05);T1~6的nb-rSO2与T 0差异无统计学意义(P>0.05)。T1~6的b-rSO2均较同时间点的nb-rSO2升高,差异有统计学意义(P<0.05)。T1~6的SBP、DBP、MAP、HR、SpO2与T0差异无统计学意义(P>0.05)。结论超声引导下SGB后b-rSO2升高,nb-rSO2无明显变化。超声引导下SGB可改善脑氧代谢,可能在围术期脑保护方面有积极作用;对无心血管疾病的清醒患者血流动力学影响较小。Objective To observe the effects of ultrasound-guided stellate ganglion block(SGB)on hemodynamics and bilateral regional cerebral oxygen saturation(rSO2),and to provide references for studies on whether SGB improve cerebral oxygen metabolism or protect brain during perioperative period.Methods Totally 45 patients with pain in head or in face or somatoform pain disorder from June 2018 to October 2018 in the First Affiliated Hospital of Zhengzhou University were selected.Unilateral SGB was performed on those patients by injecting 0.2%ropivacaine hydrochloride 4 mL at C6 level under ultrasonic guidance.The rSO2 monitor was used to observe the rSO2 on the blocked side(b-rSO2)and the rSO2 on the non-blocked side(nb-rSO2)before SGB(T0)and 5(T1),10(T2),15(T3),20(T4),25(T5)and 30(T6)minutes after SGB.SBP,DBP,MAP,HR and SpO2 at T0-T6 were measured as well.Results The increments of the b-rSO2 at T1-6 from the baseline were statistically significant(P<0.05),while the nb-rSO2 after SGB did not change significantly compared with the baseline(P>0.05).The b-rSO2 at T1-6 increased compared with the nb-rSO2 at the same time,and the differences were statistically significant(P<0.05).The SBP,DBP,MAP,HR and SpO2 at T1-6 did not change significantly compared with the parameters at T 0(P>0.05).Conclusion Ultrasound-guided SGB can increase the b-rSO2,while has little effect on the nb-rSO2.Ultrasound-guided SGB can improve the brain oxygen metabolism and may play active roles in brain protection during perioperative period.Ultrasound-guided SGB has little effect on hemodynamics of conscious patients without cardiovascular diseases.

关 键 词：超声引导 星状神经节阻滞 局部脑氧饱和度 脑氧代谢 血流动力学 

分 类 号：R745.7[医药卫生—神经病学与精神病学]