Prevention of Postoperative Palpebral Edema by Stellate Ganglion Block in Patients Undergoing Intracranial Aneurysm Surgery_West China Medical Journal

Authors：

 TengYi , OuMengchan ,  LiYu

Department of Anesthesia, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

LiYu, Email: biaojieli@tom.com

Keywords：

Stellate ganglion; Nerve block; Intracranial aneurysm; Palpebra; Edema

DOI：

10.7507/1002-0179.201600132

Video：

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Objective To investigate the efficacy of stellate ganglion block (SGB) on postoperative palpebral edema in patients undergoing intracranial aneurysm surgery. Methods Sixty patients who were scheduled to undergo intracranial aneurysm surgery between September 2012 and Novermber 2014 were recruited, and were assigned into 2 groups randomly with 30 in each:SGB group and control group. Patients in SGB group were administered SGB by injecting 0.3% ropivacaine on the operative side under the ultrasound guidance after surgery completed, while patients in the control group received injection of saline on the operative side under the ultrasound guidance. Incidence of postoperative palpebral edema at hour 24, 48, and 72 after surgery were measured. Numerical rating scale (NRS) was used to detect the severity of uncomfortable symptoms for palpebral swelling during rest state. The severity of palpebral edema was evaluated with continuous rating scale (0-5, 0 indicated normal palpebral, and higher score indicated more serious palpebral edema). Complications related with SGB were recorded. Results The overall incidence of palpebral edema at hour 24 after surgery in SGB group was lower than that in the control group (P<0.05). There was no statistically significant difference in the overall incidence of palpebral edema at hour 48 and 72 after surgery between the two groups (P>0.05). The palpebral edema rating scores of the SGB group at hour 24 after surgery were lower than those of the control group (P<0.01).The incidence of palpebral edema which was scored 3 or more at hour 24 and 48 after surgery in SGB group was lower than that in the control group (P<0.05). No statistically significant difference was found in the incidence of palpebral edema which was scored 3 or more at hour 72 after surgery between the two groups (P>0.05). No complication related with SGB was found. Conclusion SGB can safely reduce the incidence of postoperative palpebral edema in patients undergoing intracranial aneurysm surgery, and reduce the severity of palpebral edema.

Citation： TengYi, OuMengchan, LiYu. Prevention of Postoperative Palpebral Edema by Stellate Ganglion Block in Patients Undergoing Intracranial Aneurysm Surgery. West China Medical Journal, 2016, 31(3): 499-502. doi: 10.7507/1002-0179.201600132 Copy

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3.	Bindra A, Prabhakar H, Singh GP. Stellate ganglion block for relieving vasospasms after coil embolization of basilar tip aneurysms[J]. J Neurosurg Anesthesiol, 2011, 23(4):379.
4.	章放香, 殷税香, 贺纯静. 星状神经节阻滞对颅内动脉瘤手术患者脑血管痉挛的影响[J]. 中华麻醉学杂志, 2011, 31(6):729-731.
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6.	杨帆, 杨邦祥, 肖红, 等. 初学者超声引导下星状神经节阻滞与传统星状神经节阻滞准确性与安全性比较[J]. 中国疼痛医学杂志, 2008, 14(6):374-375.
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8.	Zhang L, Yao J, Zhang T, et al. Stellate ganglion block may prevent the development of neurogenic pulmonary edema and improve the outcome[J]. Med Hypotheses, 2013, 80(2):158-161.
9.	刘维刚. 星状神经节阻滞治疗妊高征效果的临床研究[J]. 中国医药导报, 2012, 9(22):69-70, 73.
10.	Elias M. Cervical sympathetic and stellate ganglion blocks[J]. Pain Physician, 2000, 3(3):294-304.
11.	Bonvento G, Lacombe P, Mackenzie ET, et al. Differential effects of electrical stimulation of the dorsal raphe nucleus and of cervical sympathectomy on serotonin and noradrenaline concentrations in major cerebral arteries and pial vessels in the rat[J]. J Cereb Blood Flow Metab, 1990, 10(1):123-126.
12.	杨帆, 蒋鹏飞. 不同浓度甲磺酸罗哌卡因的星状神经节阻滞效果[J]. 华西医学, 2014, 29(7):1248-1251.
13.	Schwartz PJ, Locati EH, Moss AJ, et al. Left cardiac sympathetic denervation in the therapy of congenital long qt syndrome-a worldwide report[J]. Circulation, 1991, 84(2):503-511.
14.	Lipov EG, Joshi JR, Sanders S, et al. Effects of stellate-ganglion block on hot flushes and night awakenings in survivors of breast cancer:a pilot study[J]. Lancet Oncol, 2008, 9(6):523-532.
15.	全守波, 王清秀, 刘菊英, 等. 星状神经节阻滞对全脑缺血再灌注损伤家兔海马及颞叶皮质热休克蛋白70表达的影响[J]. 中华麻醉学杂志, 2004, 24(2):133-137.

1. Gupta MM, Bithal PK, Dash HH, et al. Effects of stellate ganglion block on cerebral haemodynamics as assessed by transcranial Doppler ultrasonography[J]. Br J Anaesth, 2005, 95(5):669-673.
2. 王贤裕, 王清秀, 傅南安, 等. 星状神经节阻滞对兔血浆去甲肾上腺素浓度的影响[J]. 中华麻醉学杂志, 2001, 21(7):420-422.
3. Bindra A, Prabhakar H, Singh GP. Stellate ganglion block for relieving vasospasms after coil embolization of basilar tip aneurysms[J]. J Neurosurg Anesthesiol, 2011, 23(4):379.
4. 章放香, 殷税香, 贺纯静. 星状神经节阻滞对颅内动脉瘤手术患者脑血管痉挛的影响[J]. 中华麻醉学杂志, 2011, 31(6):729-731.
5. 代旭平, 栗志兵, 王津甫, 等. 超声引导与传统穿刺行星状神经节阻滞的比较[J]. 临床麻醉学杂志, 2011, 27(1):78-79.
6. 杨帆, 杨邦祥, 肖红, 等. 初学者超声引导下星状神经节阻滞与传统星状神经节阻滞准确性与安全性比较[J]. 中国疼痛医学杂志, 2008, 14(6):374-375.
7. Claassen J, Bernardini GL, Kreiter K, et al. Effect of cisternal and ventricular blood on risk of delayed cerebral ischemia after subarachnoid hemorrhage:the Fisher scale revisited[J]. Stroke, 2001, 32(9):2012-2020.
8. Zhang L, Yao J, Zhang T, et al. Stellate ganglion block may prevent the development of neurogenic pulmonary edema and improve the outcome[J]. Med Hypotheses, 2013, 80(2):158-161.
9. 刘维刚. 星状神经节阻滞治疗妊高征效果的临床研究[J]. 中国医药导报, 2012, 9(22):69-70, 73.
10. Elias M. Cervical sympathetic and stellate ganglion blocks[J]. Pain Physician, 2000, 3(3):294-304.
11. Bonvento G, Lacombe P, Mackenzie ET, et al. Differential effects of electrical stimulation of the dorsal raphe nucleus and of cervical sympathectomy on serotonin and noradrenaline concentrations in major cerebral arteries and pial vessels in the rat[J]. J Cereb Blood Flow Metab, 1990, 10(1):123-126.
12. 杨帆, 蒋鹏飞. 不同浓度甲磺酸罗哌卡因的星状神经节阻滞效果[J]. 华西医学, 2014, 29(7):1248-1251.
13. Schwartz PJ, Locati EH, Moss AJ, et al. Left cardiac sympathetic denervation in the therapy of congenital long qt syndrome-a worldwide report[J]. Circulation, 1991, 84(2):503-511.
14. Lipov EG, Joshi JR, Sanders S, et al. Effects of stellate-ganglion block on hot flushes and night awakenings in survivors of breast cancer:a pilot study[J]. Lancet Oncol, 2008, 9(6):523-532.
15. 全守波, 王清秀, 刘菊英, 等. 星状神经节阻滞对全脑缺血再灌注损伤家兔海马及颞叶皮质热休克蛋白70表达的影响[J]. 中华麻醉学杂志, 2004, 24(2):133-137.

West China Medical Journal

Prevention of Postoperative Palpebral Edema by Stellate Ganglion Block in Patients Undergoing Intracranial Aneurysm Surgery

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