Different effects of right and left stellate ganglion block on power spectra of heart rate variation

Background Left stellate ganglion block has been shown to increase heart rate and blood pressure, possible because of blockage of afferent vagal fibers from arterial baroreceptors in the aortic arch. Because efferent muscle sympathetic nerve activity (MSNA) is influenced by the arterial baroreflex, the hypothesis that left stellate ganglion block increases efferent MSNA recorded from the tibial nerve of humans was tested. Methods Twenty healthy male volunteers were sequentially assigned to one of three groups: stellate ganglion block (n = 10), in which 7 ml 1% mepivacaine was injected into the left stellate ganglion; placebo (n = 5), in which 7 ml of saline was injected into the left stellate ganglion; and intramuscular injection (n = 5), in which 7 ml mepivacaine was injected into the left deltoid muscle. Direct intraneural microneurographic recording with a tungsten microelectrode was used to record MSNA in the left tibial nerve. MSNA, heart rate, and blood pressure were recorded before and after injection in all groups. An additional five volunteers were studied with transthoracic echocardiography to examine the effect of stellate ganglion block on preload changes. Results Tibial nerve MSNA increased after mepivacaine injection to the left stellate ganglion but was unchanged after saline injection to the left stellate ganglion or mepivacaine injection into the deltoid muscle. Heart rate increased significantly after the left stellate ganglion block but did not change significantly after saline injection to the left stellate ganglion or after mepivacaine injection to the deltoid muscle. Systemic blood pressure did not change significantly in all groups. Left ventricular end-diastolic area and left ventricular end-diastolic circumference did not change after stellate ganglion block. Conclusions Tibial nerve MSNA increased during left stellate ganglion block with mepivacaine.

Download Full-text

Different Effects of Right and Left Stellate Ganglion Block on Systolic Blood Pressure and Heart Rate

Open Journal of Anesthesiology ◽

10.4236/ojanes.2013.33033 ◽

2013 ◽

Vol 03 (03) ◽

pp. 143-147 ◽

Cited By ~ 4

Author(s):

Shigeru Yokota ◽

Chikuni Taneyama ◽

Hiroshi Goto

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Systolic Blood Pressure ◽

Stellate Ganglion ◽

Stellate Ganglion Block ◽

Ganglion Block ◽

Left Stellate Ganglion

Download Full-text

Left Stellate Ganglion Block for Refractory Ventricular Tachycardia: A Case Series

Journal of the Medical Association of Thailand ◽

10.35755/jmedassocthai.2021.03.10010 ◽

2021 ◽

Vol 104 (3) ◽

pp. 506-511

Keyword(s):

Ventricular Tachycardia ◽

Ventricular Arrhythmia ◽

Stellate Ganglion ◽

Case Series ◽

Stellate Ganglion Block ◽

Definitive Treatment ◽

Ganglion Block ◽

Cardiac Implantable Electronic Devices ◽

Left Stellate Ganglion ◽

Life Threatening

Ventricular arrhythmias are usually well controlled with medical management, cardiac implantable electronic devices, or catheter ablation. However, the refractory ventricular tachycardia or fibrillation (VT/VF) is life threatening and challenging. The authors reported a case series of left stellate ganglion blocks (LSGB) in patients with refractory VT/VF, who failed pharmacological treatment and multiple traditional cardiac interventions. Five patients underwent six LSGB. Four patients had significant decreased in ventricular arrhythmia burden. Among the responders, the LSGB suppressed significant VT/VF for three to seven days. Blocks did not only temporary suppress ventricular arrhythmia, but also stabilized the condition and served as a bridge to definitive treatment such as EP ablation or heart transplantation. There was no significant hemodynamic change or devastating side effects. The outcome from the present case series suggested that LSGB could be an effective treatment and a lifesaving intervention frintractable VT/VF. Keywords: Stellate ganglion block, Refractory ventricular tachycardia, Sympathectomy

Download Full-text