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[PMID]:29419660
[Au] Autor:Kim JE; Lee MK; Lee DK; Choi SS; Park JS
[Ad] Endereço:Department of Anesthesiology and Pain medicine, Korea University, Guro Hospital, Seoul, Republic of Korea.
[Ti] Título:Continuous cervical epidural block: Treatment for intractable hiccups.
[So] Source:Medicine (Baltimore);97(6):e9444, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Intractable hiccups, although rare, may result in severe morbidity, including sleep deprivation, poor food intake, respiratory muscle fatigue, aspiration pneumonia, and death. Despite these potentially fatal complications, the etiology of intractable hiccups and definitive treatment are unknown. This study aimed to evaluate the effectiveness of continuous cervical epidural block in the treatment of intractable hiccups.Records from 28 patients with a history of unsuccessful medical and invasive treatments for hiccups were evaluated. Continuous cervical epidural block was performed with a midline approach at the C7-T1 or T1-T2 intervertebral space with the patient in the prone position. The epidural catheter was advanced through the needle in a cephalad direction to the C3-C5 level. Catheter placement was confirmed using contrast radiography. A 6-mL bolus of 0.25% ropivacaine was injected, and a continuous infusion of 4 mL/h of ropivacaine was administered through the epidural catheter using an infuser containing 0.75% ropivacaine (45 mL ropivacaine and 230 mL normal saline). When the hiccups stopped and did not recur for 48 hours, the catheter was removed.Cumulative complete remission rates were 60.71% after the first cervical epidural block, 92.86% after the second, and 100% after the third. One patient complained of dizziness that subsided. No other adverse effects were reported.Continuous C3-C5 level cervical epidural block has a successful remission rate. We suggest that continuous cervical epidural block is an effective treatment for intractable hiccups.
[Mh] Termos MeSH primário: Amidas/administração & dosagem
Bloqueio Nervoso Autônomo
Soluço
Injeções Epidurais/métodos
[Mh] Termos MeSH secundário: Adulto
Idoso
Anestésicos Locais/administração & dosagem
Bloqueio Nervoso Autônomo/efeitos adversos
Bloqueio Nervoso Autônomo/métodos
Cateterismo/métodos
Medula Cervical/efeitos dos fármacos
Medula Cervical/fisiopatologia
Tontura/etiologia
Feminino
Soluço/diagnóstico
Soluço/fisiopatologia
Soluço/terapia
Seres Humanos
Masculino
Meia-Idade
Recidiva
Indução de Remissão/métodos
República da Coreia
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Amides); 0 (Anesthetics, Local); 7IO5LYA57N (ropivacaine)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180216
[Lr] Data última revisão:
180216
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180209
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009444


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[PMID]:29208463
[Au] Autor:Hao W; Yang R; Yang Y; Jin S; Li Y; Yuan F; Guo Q; Xiao L; Wang X; Wang F; Wu Y; Teng X
[Ad] Endereço:Department of Anesthesiology, Hebei Provincial Hospital of traditional Chinese Medicine, Shijiazhuang 050011, China.
[Ti] Título:Stellate ganglion block ameliorates vascular calcification by inhibiting endoplasmic reticulum stress.
[So] Source:Life Sci;193:1-8, 2018 Jan 15.
[Is] ISSN:1879-0631
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:AIMS: Vascular calcification (VC) underlies substantial cardiovascular morbidity and mortality. No clinically therapies have emerged presently. Stellate ganglion block (SGB) is one of the most often used sympathetic blockade procedure, and regulates vascular dilation. However, the effect of SGB on VC is still unknown. Therefore, we aimed to identify the ameliorative effect of SGB on VC. KEY FINDING: In vivo VC was induced in rats by administering vitamin D3 plus nicotine (VDN), and in vitro calcification of rat aortic vascular smooth muscle cells (VSMC) was induced by ß-glycerophosphate. In VDN rats, alkaline phosphatase (ALP) activity and Calcium contents were higher than that in control rats. The transformation of VSMC from contractile to osteoblast-like phenotype was observed in calcified aorta. SGB ameliorated the increase of ALP activity and Calcium content, and the transformation of VSMC in calcified aorta. The stimulation of endoplasmic reticulum stress (ERS) in calcified aorta was also attenuated by SGB treatment. The inducer of ERS, tunicamycin could block the beneficial effect of SGB on VC, and the ERS inhibitor, 4-PBA could mimic the amelioration of SGB. Furthermore, SGB attenuated the increased plasma levels of norepinephrine in VDN rats. In vitro experiments, norepinephrine exaggerated VSMC calcification, phenotype transformation and ERS. SIGNIFICANCE: These results demonstrate that SGB could inhibit sympathetic nervous activity, and then prevent the activation of ERS followed by ameliorating VC. Sympathetic over-activation might play critical role in the pathogenesis of VC, which provides new strategy and target for therapy and prevention of VC.
[Mh] Termos MeSH primário: Estresse do Retículo Endoplasmático/efeitos dos fármacos
Gânglio Estrelado/fisiologia
Calcificação Vascular/terapia
[Mh] Termos MeSH secundário: Animais
Aorta/patologia
Bloqueio Nervoso Autônomo/métodos
Cálcio/farmacologia
Colecalciferol/farmacologia
Modelos Animais de Doenças
Retículo Endoplasmático/metabolismo
Estresse do Retículo Endoplasmático/fisiologia
Glicerofosfatos
Masculino
Músculo Liso Vascular/efeitos dos fármacos
Miócitos de Músculo Liso/patologia
Nicotina/farmacologia
Nordefrin
Ratos
Ratos Sprague-Dawley
Transdução de Sinais
Gânglio Estrelado/metabolismo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Glycerophosphates); 1C6V77QF41 (Cholecalciferol); 6M3C89ZY6R (Nicotine); R81X549E70 (Nordefrin); SY7Q814VUP (Calcium); WWH06G87W6 (beta-glycerophosphoric acid)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180108
[Lr] Data última revisão:
180108
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171207
[St] Status:MEDLINE


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[PMID]:28455598
[Au] Autor:Kim H; Song SO; Jung G
[Ad] Endereço:Department Anesthesiology and Pain Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea.
[Ti] Título:A lateral paracarotid approach for ultrasound-guided stellate ganglion block with a linear probe.
[So] Source:J Anesth;31(3):458-462, 2017 Jun.
[Is] ISSN:1438-8359
[Cp] País de publicação:Japan
[La] Idioma:eng
[Ab] Resumo:Recent reports suggest that ultrasound-guided stellate ganglion block (SGB) is safer and more accurate than classic SGB by the using the surface anatomical landmark. However, previous reports concern the classic paratracheal approach using a small specialized curved probe, which may not be appropriate in some patients. The authors have attempted several approaches, including paratracheal, trans-thyroidal, lateral paracarotid, and lateral approaches, to find a safe and suitable method for real-time ultrasound-guided SGB using a standard high-frequency linear probe. A total of 27 injections were performed on 27 patients with sensorineural hearing loss. The lateral paracarotid out-of-plane and lateral in-plane approaches were identified as the easiest and safest methods among the four tested. In this report, we describe a new lateral paracarotid approach for ultrasound-guided SGB. An ipsilateral paratracheal short-axis transverse scan was acquired at the C6 level with a linear probe (6-13 MHz). The probe was moved laterally, scanning the thyroid, carotid artery, internal jugular vein, longus colli muscle, and the transverse process of the C6, placing the carotid artery in the middle of the view. Light pressure was applied to the probe postero-medially to displace the carotid artery medially and completely compress the internal jugular vein. The needle was inserted out-of-plane between the lateral margin of the carotid artery and Chassaignac's tubercle, traversing the collapsed internal jugular vein, and targeted between the longus colli muscle and the prevertebral fascia. A total of 4 ml of 0.2% ropivacaine was injected for each procedure after a negative aspiration test. Successful blockade was confirmed with the onset of Horner's sign. All 27 injections resulted in successful blockade with Horner's sign presenting within 5 min after injection. Side effects were minor and caused minimal discomfort; they included hoarseness and a foreign body sensation. No hematomas formed after any injections. We suggest that this new lateral paracarotid approach, with out-of plane needle insertion at the C6 tubercle under transverse scan, is a convenient and safe method for performing real-time ultrasound-guided SGB, as it provides a wide, safe space for needle passage without risking thyroid or esophageal injury.
[Mh] Termos MeSH primário: Amidas/administração & dosagem
Anestesia Local/métodos
Bloqueio Nervoso Autônomo/métodos
[Mh] Termos MeSH secundário: Adulto
Idoso
Vértebras Cervicais/diagnóstico por imagem
Feminino
Seres Humanos
Injeções
Masculino
Meia-Idade
Pescoço/diagnóstico por imagem
Agulhas
Gânglio Estrelado
Ultrassonografia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Amides); 7IO5LYA57N (ropivacaine)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171207
[Lr] Data última revisão:
171207
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170430
[St] Status:MEDLINE
[do] DOI:10.1007/s00540-017-2354-y


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[PMID]:28917344
[Au] Autor:Sahai AV
[Ad] Endereço:Service de Gastroentérologie, CHUM, Hôpital Saint Luc, Montréal, Québec, Canada.
[Ti] Título:EUS-guided celiac ganglia neurolysis versus celiac plexus neurolysis: dying to know which is better.
[So] Source:Gastrointest Endosc;86(4):664-665, 2017 10.
[Is] ISSN:1097-6779
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Plexo Celíaco
Gânglios Simpáticos
[Mh] Termos MeSH secundário: Bloqueio Nervoso Autônomo
Endossonografia
Seres Humanos
[Pt] Tipo de publicação:EDITORIAL; COMMENT
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171031
[Lr] Data última revisão:
171031
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170918
[St] Status:MEDLINE


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[PMID]:28859148
[Au] Autor:Wang W; Shi W; Qian H; Deng X; Wang T; Li W
[Ad] Endereço:Department of Anaesthesiology, Second Affiliated Hospital of Harbin Medical University, Harbin, China.
[Ti] Título:Stellate ganglion block attenuates chronic stress induced depression in rats.
[So] Source:PLoS One;12(8):e0183995, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Stress is a significant factor in the etiology of depression. Stellate ganglion block (SGB) has been shown to maintain the stability of the autonomic system and to affect the neuroendocrine system, including the hypothalamic-pituitary-adrenal (HPA) axis. The objective of this study was to determine the antidepressant-like effects of SGB on the autonomic system and the HPA axis, apoptosis-related proteins, related spatial learning and memory impairment, and sensorimotor dysfunction. METHODS: Forty-eight Sprague Dawley rats were assigned to four experimental groups: control + saline (sham group), control + SGB (SGB group), unpredictable chronic mild stress (UCMS) + saline (UCMS group), and UCMS + SGB (UCSG group). Stress-induced effects and the function of SGB were assessed using measures of body weight, coat state, sucrose consumption, and behavior in open-field and Y-maze tests. Neuronal damage was assessed histologically using the hematoxylin-eosin (HE) staining method, while western blotting was used to investigate changes in the expression of apoptosis-related proteins. Plasma corticotropin-releasing factor (CRF), adrenocorticotropic hormone (ACTH), corticosterone (CORT), noradrenaline and adrenaline were measured to evaluate changes in the autonomic system and HPA axis. RESULTS: SGB treatment significantly improved sensorimotor dysfunction and spatial learning and memory impairment following UCMS. Moreover, UCMS significantly decreased body weight, sucrose preference and anti-apoptotic protein Bcl-2, and increased scores on measures of coat state, adrenal gland weight, levels of CORT, CRF, ACTH, noradrenaline and adrenaline, as well as increased neuronal loss, cell shrinkage, nuclear condensation, and the pro-apoptotic protein Bax. These symptoms were attenuated by treatment with SGB. CONCLUSIONS: These findings suggest that SGB can attenuate depression-like behaviors induced by chronic stress. These protective effects appear to be due to an anti-apoptotic mechanism of two stress pathways-the autonomic system and the HPA axis.
[Mh] Termos MeSH primário: Bloqueio Nervoso Autônomo
Depressão/tratamento farmacológico
Sistema Hipotálamo-Hipofisário/efeitos dos fármacos
Sistema Hipófise-Suprarrenal/efeitos dos fármacos
Gânglio Estrelado/efeitos dos fármacos
Estresse Psicológico/prevenção & controle
[Mh] Termos MeSH secundário: Hormônio Adrenocorticotrópico/sangue
Hormônio Adrenocorticotrópico/genética
Anestésicos Locais
Animais
Peso Corporal/efeitos dos fármacos
Bupivacaína
Corticosterona/sangue
Hormônio Liberador da Corticotropina/sangue
Hormônio Liberador da Corticotropina/genética
Depressão/metabolismo
Depressão/fisiopatologia
Epinefrina/sangue
Expressão Gênica
Sistema Hipotálamo-Hipofisário/metabolismo
Sistema Hipotálamo-Hipofisário/fisiopatologia
Masculino
Aprendizagem em Labirinto/efeitos dos fármacos
Neurônios/efeitos dos fármacos
Neurônios/metabolismo
Neurônios/patologia
Norepinefrina/sangue
Sistema Hipófise-Suprarrenal/metabolismo
Sistema Hipófise-Suprarrenal/fisiopatologia
Proteínas Proto-Oncogênicas c-bcl-2/sangue
Proteínas Proto-Oncogênicas c-bcl-2/genética
Desempenho Psicomotor/efeitos dos fármacos
Ratos
Ratos Sprague-Dawley
Estresse Psicológico/metabolismo
Estresse Psicológico/fisiopatologia
Proteína X Associada a bcl-2/sangue
Proteína X Associada a bcl-2/genética
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anesthetics, Local); 0 (Bax protein, rat); 0 (Bcl2 protein, rat); 0 (Proto-Oncogene Proteins c-bcl-2); 0 (bcl-2-Associated X Protein); 9002-60-2 (Adrenocorticotropic Hormone); 9015-71-8 (Corticotropin-Releasing Hormone); W980KJ009P (Corticosterone); X4W3ENH1CV (Norepinephrine); Y8335394RO (Bupivacaine); YKH834O4BH (Epinephrine)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171016
[Lr] Data última revisão:
171016
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170901
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0183995


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[PMID]:28533676
[Au] Autor:Lipov E; Candido K
[Ad] Endereço:Eugene Lipov, Ken Candido, Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago, IL 60657, United States.
[Ti] Título:Efficacy and safety of stellate ganglion block in chronic ulcerative colitis.
[So] Source:World J Gastroenterol;23(17):3193-3194, 2017 May 07.
[Is] ISSN:2219-2840
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Sympathetic system modulation by stellate ganglion blockade may modulate immune dysfunction and significantly improve symptoms of chronic ulcerative colitis.
[Mh] Termos MeSH primário: Colite Ulcerativa
Gânglio Estrelado
[Mh] Termos MeSH secundário: Anestesia Local
Bloqueio Nervoso Autônomo
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; COMMENT
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170526
[Lr] Data última revisão:
170526
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170524
[St] Status:MEDLINE
[do] DOI:10.3748/wjg.v23.i17.3193


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[PMID]:28339435
[Au] Autor:Oh TK; Lee WJ; Woo SM; Kim NW; Yim J; Kim DH
[Ad] Endereço:Department of Anesthesiology and Pain Medicine, National Cancer Center, Goyang, Republic of Korea.
[Ti] Título:Impact of Celiac Plexus Neurolysis on Survival in Patients with Unresectable Pancreatic Cancer: A Retrospective, Propensity Score Matching Analysis.
[So] Source:Pain Physician;20(3):E357-E365, 2017 Mar.
[Is] ISSN:2150-1149
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Pain caused by pancreatic cancer (PC) is difficult to control. Celiac plexus neurolysis (CPN) can effectively control the pain and reduce the use of opioids. However, the effect of CPN on survival for patients with unresectable PC remains controversial. OBJECTIVES: To determine if CPN is associated with survival benefits for these patients. STUDY DESIGN: Retrospective, observational cohort study. SETTING: National Cancer Center in Korea. METHODS: The CPN group included patients who were diagnosed with unresectable PC and underwent fluoroscopically guided bilateral CPN (10 mL dehydrated alcohol each side) once between January 1, 2006, and December 31, 2013. Patients with PC who did not undergo CPN were in the control group; for the final control group, 1:1 propensity score (PS) matching was conducted with the CPN group. The main outcome was median survival (PC diagnosis to death) after PS matching, assessed using Kaplan-Meier curves. RESULTS: For the primary overall survival analysis, the CPN and control groups included 110 and 258 patients, respectively. The median survival period was not significantly different between the CPN and control groups (278 vs. 203 days, P = 0.246), even after PS matching (278 vs. 180 days, P = 0.127), or based on time to CPN from diagnosis (≤ 6 vs. > 6 months; 255 vs. 310 days, P = 0.147). LIMITATIONS: Retrospective design, small sample size, and inconsistent timing of CPN after the diagnosis date. CONCLUSION: CPN did not affect survival for patients with unresectable PC. Considering the limitations of the retrospective design, a well-designed prospective design study should be conducted.Key words: Celiac plexus, pancreatic neoplasms, survival, neurolysis, pain, propensity score matching, opioids, cancer.
[Mh] Termos MeSH primário: Bloqueio Nervoso Autônomo/métodos
Plexo Celíaco/fisiopatologia
Manejo da Dor/métodos
Dor/fisiopatologia
Neoplasias Pancreáticas/fisiopatologia
[Mh] Termos MeSH secundário: Idoso
Feminino
Seres Humanos
Masculino
Meia-Idade
Pontuação de Propensão
República da Coreia
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170717
[Lr] Data última revisão:
170717
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170325
[St] Status:MEDLINE


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[PMID]:28319552
[Au] Autor:Kim WJ; Park HS; Yi MS; Koo GH; Shin HY
[Ad] Endereço:*From the Department of Anesthesiology and Pain Medicine, School of Medicine, Ewha Womans University; and †Department of Anesthesiology and Pain Medicine, School of Medicine, Chung-Ang University, Seoul, Korea.
[Ti] Título:Evaluation of Lung Function and Clinical Features of the Ultrasound-Guided Stellate Ganglion Block With 2 Different Concentrations of a Local Anesthetic: A Randomized Controlled Trial.
[So] Source:Anesth Analg;124(4):1311-1316, 2017 Apr.
[Is] ISSN:1526-7598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: One possible complication of stellate ganglion block (SGB) is respiratory compromise. No study has yet addressed the comparison of its effect on lung function and clinical features, including Horner's syndrome, changes in temperature, sensory and motor functions, and adverse events of lower versus higher concentrations (LC and HC, respectively) of local anesthetics in an ultrasound-guided SGB. METHODS: Fifty patients were randomized into 1 of 2 groups: the LC group (5 mL of 0.5% mepivacaine) and the HC group (5 mL of 1% mepivacaine). One anesthesiologist performed a C6- SGB under ultrasound guidance. Our primary objective was to compare LC and HC of a local anesthetic in terms of its effect on lung function, and the secondary objective was to compare the clinical features between LC and HC of a local anesthetic. Lung function was compared between the 2 groups using the Mann-Whitney U test. RESULTS: The forced vital capacity at 20 minutes post-SGB was not significantly different between the HC and the LC groups (P = .360); the median difference (95% confidence intervals [CI]) was 1 (-1 to 8). Other parameters of lung function were comparable with the forced vital capacity. Patients in the HC group had significantly greater sensory changes than those in the LC group (% decrease compared with the unblocked side); 95.4 ± 2.1 (CI: 91.11-99.73) vs 87.3 ± 3.5 (CI: 80.12-94.49). CONCLUSIONS: Lung function between the LC and HC groups after SGB did not differ significantly. Clinical features between the 2 groups also did not differ clinically, except that patients in the HC group had significantly greater sensory loss in the C6 dermatomes.
[Mh] Termos MeSH primário: Anestésicos Locais/administração & dosagem
Bloqueio Nervoso Autônomo/métodos
Fenômenos Fisiológicos Respiratórios/efeitos dos fármacos
Gânglio Estrelado/efeitos dos fármacos
Gânglio Estrelado/diagnóstico por imagem
Ultrassonografia de Intervenção/métodos
[Mh] Termos MeSH secundário: Adulto
Idoso
Relação Dose-Resposta a Droga
Feminino
Seres Humanos
Masculino
Mepivacaína/administração & dosagem
Meia-Idade
Projetos Piloto
Testes de Função Respiratória/métodos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Anesthetics, Local); B6E06QE59J (Mepivacaine)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170713
[Lr] Data última revisão:
170713
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170321
[St] Status:MEDLINE
[do] DOI:10.1213/ANE.0000000000001945


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[PMID]:28235510
[Au] Autor:Chen YQ; Xie YY; Wang B; Jin XJ
[Ad] Endereço:Department of Anesthesiology, First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui 241001, China. Electronic address: yongquanchencn@126.com.
[Ti] Título:Effect of stellate ganglion block on hemodynamics and stress responses during CO -pneumoperitoneum in elderly patients.
[So] Source:J Clin Anesth;37:149-153, 2017 Feb.
[Is] ISSN:1873-4529
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:STUDY OBJECTIVE: Elderly patients undergoing elective laparoscopic cholecystectomy (LC) were given right stellate ganglion block (RSGB) to observe its effects on the hemodynamics and stress response during carbon dioxide (CO )-pneumoperitoneum. DESIGN: A randomized, single-blinded, and placebo-controlled study. SETTING: University-affiliated teaching hospital. PARTICIPANTS: Sixty patients (aged 65-78years; weight, 45-75kg; American Society of Anesthesiologists (ASA) physical status classification, class I or II) undergoing elective LC. INTERVENTIONS: Right stellate ganglion block was performed via C7 access using 10mL of 1% lidocaine in all patients. MEASUREMENTS: The patients' heart rate (HR) and mean arterial pressure (MAP) were recorded before the block (T ), 5min following pneumoperitoneum (T ), 30min following pneumoperitoneum (T ), 5min following the deflation of pneumoperitoneum (T ), and upon completion of the surgery (T ). Additionally, the concentrations of epinephrine (E), norepinephrine (NE) and cortisol (COR) were detected in arterial blood at each time point by enzyme-linked immunosorbent assay. MAIN RESULTS: For control group, the MAP and RPP (RPP=SBP×HR) were significantly elevated at T (P<0.05) as compared to T . Inter-group comparison showed that the MAP, HR and RPP were significantly lower at T in RSGB group (P<0.05 or 0.01). As compared to T , the E, NE and COR levels significantly rose at T in control group (P<0.05 or 0.01) and COR at T in RSGB group (P<0.05). The E, NE and COR levels at T were significantly lower in RSGB group as compared to control group (P<0.05 or 0.01). CONCLUSION: Right stellate ganglion block can reduce blood catecholamines during CO -pneumoperitoneum to maintain perioperative hemodynamic stability and prevent adverse cardiovascular events in elderly patients.
[Mh] Termos MeSH primário: Bloqueio Nervoso Autônomo/métodos
Colecistectomia Laparoscópica/efeitos adversos
Procedimentos Cirúrgicos Eletivos/efeitos adversos
Pneumoperitônio Artificial/efeitos adversos
Gânglio Estrelado/efeitos dos fármacos
[Mh] Termos MeSH secundário: Idoso
Anestesia Geral
Pressão Arterial
Dióxido de Carbono/administração & dosagem
Ensaio de Imunoadsorção Enzimática
Epinefrina/sangue
Feminino
Frequência Cardíaca
Seres Humanos
Hidrocortisona/sangue
Lidocaína/administração & dosagem
Masculino
Norepinefrina/sangue
Assistência Perioperatória/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
142M471B3J (Carbon Dioxide); 98PI200987 (Lidocaine); WI4X0X7BPJ (Hydrocortisone); X4W3ENH1CV (Norepinephrine); YKH834O4BH (Epinephrine)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170914
[Lr] Data última revisão:
170914
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170226
[St] Status:MEDLINE


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[PMID]:28222636
[Au] Autor:Joo EY; Kong YG; Lee J; Cho HS; Kim SH; Suh JH
[Ad] Endereço:Department of Anesthesiology and Pain Medicine, University of Ulsan College of Medicine, Seoul, Republic of Korea.
[Ti] Título:Change in pulse transit time in the lower extremity after lumbar sympathetic ganglion block: an early indicator of successful block.
[So] Source:J Int Med Res;45(1):203-210, 2017 Feb.
[Is] ISSN:1473-2300
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Objective To investigate the change in pulse transit time (PTT)-time between the electrocardiographic R wave and the highest point of the corresponding plethysmographic wave-after lumbar sympathetic ganglion block (LSGB) and evaluate PTT as an indicator of successful LSGB. Methods Sixteen cases of sympathetically mediated lower extremity neuropathic pain treated with LSGB were studied. Correlations between the changes in PTT and temperature were used to identify the cutoff point indicating successful LSGB. Results PTT rate of change at 5 min relative to the baseline PTT (dPTT5/PTT0) significantly correlated positively with the temperature change at 20 min (correlation coefficient 0.734). The dPTT5/PTT0 ratios of the Success and Failure groups were 6.46 ± 2.81% and 2.77 ± 1.72%, respectively. The dPTT5/PTT0 cutoff indicating successful LSGB, based on receiver operating characteristic curve analysis, was 4.23%. Conclusion PTT measurement 5 min after local anesthetic injection was an early, objective indicator of successful or failed LSGB.
[Mh] Termos MeSH primário: Anestésicos Locais
Bloqueio Nervoso Autônomo
Gânglios Simpáticos/diagnóstico por imagem
Neuralgia/terapia
Análise de Onda de Pulso/métodos
[Mh] Termos MeSH secundário: Adulto
Idoso
Eletrocardiografia
Feminino
Gânglios Simpáticos/fisiopatologia
Seres Humanos
Extremidade Inferior/diagnóstico por imagem
Extremidade Inferior/inervação
Extremidade Inferior/fisiopatologia
Região Lombossacral/inervação
Masculino
Meia-Idade
Neuralgia/diagnóstico por imagem
Neuralgia/fisiopatologia
Oximetria
Pletismografia
Análise de Onda de Pulso/instrumentação
Curva ROC
Estudos Retrospectivos
Temperatura Ambiente
Resultado do Tratamento
[Pt] Tipo de publicação:CLINICAL TRIAL; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anesthetics, Local)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:171004
[Lr] Data última revisão:
171004
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170223
[St] Status:MEDLINE
[do] DOI:10.1177/0300060516681398



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