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Effect of Right Stellate Ganglion Block on Cardiovascular Response during the Endotracheal Intubation under the General Anesthesia

【摘要】　目的　观察右星状神经节阻滞（R-SGB）对全身麻醉气管内插管期心血管反应的影响。　方法　2009年10-12月选取60例美国麻醉医师协会（ASA）Ⅰ、Ⅱ级择期全麻手术患者，随机分为3组。研究组于全麻诱导前15 min用1%利多卡因10 mL经颈6入路行R-SGB，对照组1诱导前同法注射10 mL生理盐水，对照组2诱导前肌注2%利多卡因5 mL。观察气管插管前后收缩压（SBP）、舒张压（DBP）、平均动脉压（MBP）、心率（HR）、心电图（ECG）、氧饱和度（SpO2）和心率收缩压乘积（RPP）的变化。　结果　研究组各时点与进入手术室时的基础值比较，仅诱导后SBP、DBP、MBP显著降低，窥喉时HR和RPP显著升高（Plt;0.01）；在插管3 min后已恢复至基础值。对照组1和对照组2诱导后SBP、DBP、MBP显著降低（Plt;0.01）；窥喉时SBP、DBP、MBP、HR、RPP均显著升高（Plt;0.01），并持续至插管后5 min。两对照组升高的程度均显著高于研究组（Plt;0.05或Plt;0.01）。　结论　R-SGB对全麻气管插管期的心血管反应有一定抑制作用，可用于调控全麻插管期心血管不良反应。【Abstract】　Objective　To explore the effect of right stellate ganglion block (R-SGB) on cardiovascular response during endotracheal intubation under the general anesthesia.　Methods　Sixty ASAⅠ-Ⅱpatients who underwent general anaesthesia between October to December 2009 were randomly divided into three groups. The patients in the trial group accepted R-SGB by C6 route with 1% lidocaine (10 mL) 15 minutes before induction of general anesthesia; the patients in control group 1 were injected with 10 mL physiological saline in the same way before the induction; the patients in control group 2 underwent the intramuscular injection of 2% lidocaine (5 mL) before the induction. The changes of systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), hear rate (HR), electrocardiogram (ECG), oxygen saturation (SpO2) and heart rate-systolic blood pressure product (RPP) before and after endotracheal intubation were observed and recorded.　Results　In the trial group, SBP, MAP, and DBP decreased significantly after the induction; HR and RPP increased evidently at the laryngeal exposure compared with the baseline values (Plt;0.01) and recovered three minutes after the intubation. In the control group 1 and 2, SBP, MAP, and DBP decreased significantly after induction (Plt;0.01); SBP, MAP, DBP, HR and RPP increased apparently at the laryngeal exposure compared with the baseline values (Plt;0.01), and the raise continued until five minutes after endotracheal intubation. The difference in the raise between the control groups and the trial group was significant (Plt;0.05 or Plt;0.01).　Conclusion　R-SGB may effectively inhibit the cardiovascular response during endotracheal intubation under the general anesthesia and can be used to control the negative reaction during the induction.