scholarly journals Effect of stellate ganglion block on postoperative recovery of gastrointestinal function in patients undergoing surgery with general anaesthesia: a meta-analysis

BMC Surgery ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Bei Wen ◽  
Yajie Wang ◽  
Cong Zhang ◽  
Zhijian Fu
Keyword(s):  
General Anaesthesia ◽  
Meta Analysis ◽  
Stellate Ganglion ◽  
Gastrointestinal Surgery ◽  
Stellate Ganglion Block ◽  
Postoperative Recovery ◽  
Cochrane Library ◽  
Gastrointestinal Function ◽  
Ganglion Block ◽  
Abdominal Bloating

Abstract Background The return of gastrointestinal function is an important sign of postoperative recovery in patients undergoing surgery with general anaesthesia. We aimed to summarize the effects of stellate ganglion block on the recovery of gastrointestinal function as a means of exploring methods through which anaesthesiologists can contribute to postoperative patient recovery. Methods We performed a quantitative systematic review of randomized controlled trials published between January 1, 1988, and November 11, 2019, in PubMed, the Cochrane Library, China National Knowledge Infrastructure, Chinese VIP Information, and the Wanfang and SinoMed databases. Study quality was assessed by using the GRADE criteria and bias of included studies were assessed using the revised Cochrane risk-of-bias tool for randomized trials. The time to peristaltic sound resumption, flatus, postoperative eating and the incidence of abdominal bloating in the stellate ganglion block and control groups were compared. The control group consisted of either a stellate ganglion block with normal saline or no treatment. Meta-analysis was performed using Review Manager software. Results After searching for relevant articles, 281 studies were identified, and five articles with data on 274 patients were eligible. Regarding postoperative flatus time, stellate ganglion block resulted in a mean reduction of 15 h (P = 0.02); then a sensitivity analysis was performed, and the standard mean difference decreased to 6 h (P = 0.007). For gastrointestinal surgery, the mean reduction was 23.92 h (P = 0.0002). As for the evaluation of the recovery of peristaltic sounds, stellate ganglion block promoted the recovery of regular peristaltic bowel sounds an average of 14.67 h earlier than in the control (P = 0.0008). When it comes to nutrients, stellate ganglion block shortened the total parenteral nutrition time by more than 50 h in patients who had undergone gastrointestinal surgery (P<0.00001). Finally, stellate ganglion block prevented the occurrence of postoperative abdominal bloating (P = 0.001).) No complications related to stellate ganglion block were reported. Conclusion Stellate ganglion block may promote postoperative gastrointestinal recovery in patients undergoing various surgeries under general anaesthesia. However, additional trials investigating the use of stellate ganglion block are necessary to confirm our finding. Trial registration This meta-analysis has been registered at the International Prospective Register of Systematic Reviews (registration number CRD42020157602).

scholarly journals Effect of stellate ganglion block on postoperative recovery of gastrointestinal function in patients undergoing surgery with general anaesthesia: a meta-analysis

2020 ◽  
Author(s):  
Bei Wen ◽  
Yajie Wang ◽  
Cong Zhang ◽  
Zhijian Fu
Keyword(s):  
General Anaesthesia ◽  
Meta Analysis ◽  
Stellate Ganglion ◽  
Gastrointestinal Surgery ◽  
Stellate Ganglion Block ◽  
Postoperative Recovery ◽  
Cochrane Library ◽  
Gastrointestinal Function ◽  
Ganglion Block ◽  
Abdominal Bloating

Abstract Background: The return of gastrointestinal function is an important sign of postoperative recovery in patients undergoing surgery with general anaesthesia. We aimed to summarize the effects of stellate ganglion block on the recovery of gastrointestinal function as a means of exploring methods through which anaesthesiologists can contribute to postoperative patient recovery. Methods: We performed a quantitative systematic review of randomized controlled trials published between January 1, 1988, and November 11, 2019, in PubMed, the Cochrane Library, China National Knowledge Infrastructure, Chinese VIP Information, and the Wanfang and SinoMed databases. Study quality was assessed by using the GRADE criteria and bias of included studies were assessed using the revised Cochrane risk-of-bias tool for randomized trials. The time to peristaltic sound resumption, flatus, postoperative eating and the incidence of abdominal bloating in the stellate ganglion block and control groups were compared. The control group consisted of either a stellate ganglion block with normal saline or no treatment. Meta-analysis was performed using Review Manager software.Results: After searching for relevant articles, 281 studies were identified, and five articles with data on 274 patients were eligible. Regarding postoperative flatus time, stellate ganglion block resulted in a mean reduction of 15 hours (P=0.02); then a sensitivity analysis was performed, and the standard mean difference decreased to 6 hours (P=0.007). For gastrointestinal surgery, the mean reduction was 23.92 hours (P=0.0002). As for the evaluation of the recovery of peristaltic sounds, stellate ganglion block promoted the recovery of regular peristaltic bowel sounds an average of 14.67 hours earlier than in the control (P=0.0008). When it comes to nutrients, stellate ganglion block shortened the total parenteral nutrition time by more than 50 hours in patients who had undergone gastrointestinal surgery (P＜0.00001). Finally, stellate ganglion block prevented the occurrence of postoperative abdominal bloating (P=0.001).) No complications related to stellate ganglion block were reported.Conclusion: Stellate ganglion block may promote postoperative gastrointestinal recovery in patients undergoing various surgeries under general anaesthesia. However, additional trials investigating the use of stellate ganglion block are necessary to confirm our finding.Trial registration: This meta-analysis has been registered at the International Prospective Register of Systematic Reviews (registration number CRD42020157602).

scholarly journals Effect of stellate ganglion block on postoperative recovery of gastrointestinal function in patients undergoing surgery with general anaesthesia: a meta-analysis.

2020 ◽  
Author(s):  
Bei Wen ◽  
Yajie Wang ◽  
Cong Zhang ◽  
Zhijian Fu
Keyword(s):  
General Anaesthesia ◽  
Meta Analysis ◽  
Stellate Ganglion ◽  
Gastrointestinal Surgery ◽  
Stellate Ganglion Block ◽  
Postoperative Recovery ◽  
Cochrane Library ◽  
Gastrointestinal Function ◽  
Ganglion Block ◽  
Abdominal Bloating

Abstract Background: The return of gastrointestinal function is an important sign of postoperative recovery in patients undergoing surgery with general anaesthesia. We aimed to summarize the effects of stellate ganglion block on the recovery of gastrointestinal function as a means of exploring methods through which anaesthesiologists can contribute to postoperative patient recovery. Methods: We performed a quantitative systematic review of randomized controlled trials published between January 1, 1988, and November 11, 2019, in PubMed, the Cochrane Library, China National Knowledge Infrastructure, Chinese VIP Information, and the Wanfang and SinoMed databases. Study quality was assessed using the revised Cochrane risk-of-bias tool for randomized trials. The time to peristaltic sound resumption, flatus, postoperative eating and the incidence of abdominal bloating in the stellate ganglion block and control groups were compared. The control group included patients in whom the stellate ganglion received an injection of normal saline or no treatment. Meta-analysis was performed using Review Manager software. Results: After searching for relevant articles, 281 studies were identified, and five articles with data on 274 patients were eligible. Regarding postoperative flatus time, stellate ganglion block resulted in a mean reduction of 15 hours (P=0.02); then a sensitivity analysis was performed, and the standard mean difference decreased to 6 hours (P=0.007). For gastrointestinal surgery, the mean reduction was approximately an entire day (P=0.0002). Regarding the evaluation of the recovery of peristaltic sounds, stellate ganglion block promoted the recovery of regular peristaltic bowel sounds an average of 14.67 hours earlier than in the control (P=0.0008). With regard to nutrients, stellate ganglion block shortened the total parenteral nutrition time by more than 50 hours in patients who had undergone gastrointestinal surgery (P＜0.00001). Finally, stellate ganglion block prevented the occurrence of postoperative abdominal bloating (P=0.001).) No complications related to stellate ganglion block were reported. Conclusion: Stellate ganglion block may promote postoperative gastrointestinal recovery in patients undergoing various surgeries under general anaesthesia. However, additional trials investigating the use of stellate ganglion block are necessary to confirm our finding. Trial registration: This meta-analysis has been registered at the International Prospective Register of Systematic Reviews (registration number CRD42020157602).

scholarly journals Effect of Stellate Ganglion Block on Postoperative Recovery of Gastrointestinal Function in Patients Undergoing Surgery with General Anaesthesia: A Meta-Analysis.

2020 ◽  
Author(s):  
Bei Wen ◽  
Yajie Wang ◽  
Cong Zhang ◽  
Zhijian Fu
Keyword(s):  
General Anaesthesia ◽  
Meta Analysis ◽  
Stellate Ganglion ◽  
Gastrointestinal Surgery ◽  
Stellate Ganglion Block ◽  
Postoperative Recovery ◽  
Gastrointestinal Function ◽  
Ganglion Block ◽  
Abdominal Bloating ◽  
The Mean

Abstract Background: The return of normal gastrointestinal function is an important signal of postoperative recovery in patients undergoing surgery with general anaesthesia, especially for abdominal surgery. Current methods to resolve this problem are conservative, and the effects are sometimes limited. We aimed to summarize the effects of stellate ganglion block(SGB) on the recovery of gastrointestinal function to explore methods for anaesthesiologists to contribute to postoperative patient recovery. RuMethods: Selected databases were searched for relevant studies. Study quality was assessed according to the Cochrane Collaboration’s tool for assessing risk of bias. Data extraction was performed independently. The time to peristaltic sound resumption, flatus, postoperative eating and the incidence and degree of abdominal bloating were compared between stellate ganglion and control groups. Meta-analysis was performed using Review Manager software. Results: In total, 281 studies were identified after searching for relevant articles, and five articles with data for 274 patients were eligible for this analysis. Regarding postoperative flatus time, SGB caused a mean reduction of 15 hours for different surgeries; after excluding a study causing heterogeneity, the mean reduction was still more than 6 hours. For gastrointestinal surgery, the mean reduction was approximately an entire day. When evaluating the recovery of peristaltic sounds in different surgeries, SGB promoted the recovery of regular bowl sounds by an average of 14.67 hours earlier than the control. With regard to nutrients, SGB shortened the total parenteral nutrition time by more than 50 hours in gastrointestinal surgery. Finally, SGB prevented the occurrence of postoperative abdominal bloating without influencing its degree. No complications related to SGB were reported. Conclusion: SGB promotes postoperative gastrointestinal recovery in patients undergoing different surgeries with general anaesthesia.

Decrease of blood flow velocity in the middle cerebral artery after stellate ganglion block following aneurysmal subarachnoid hemorrhage: a potential vasospasm treatment?

2020 ◽  
Vol 133 (3) ◽  
pp. 773-779
Author(s):  
Christopher Wendel ◽  
Ricardo Scheibe ◽  
Sören Wagner ◽  
Wiebke Tangemann ◽  
Hans Henkes ◽  
...  
Keyword(s):  
Blood Flow ◽  
Subarachnoid Hemorrhage ◽  
Middle Cerebral Artery ◽  
Flow Velocity ◽  
Neurological Deficit ◽  
Blood Flow Velocity ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Stellate Ganglion ◽  
Stellate Ganglion Block ◽  
Ganglion Block

OBJECTIVECerebral vasospasm (CV) is a delayed, sustained contraction of the cerebral arteries that tends to occur 3–14 days after aneurysmal subarachnoid hemorrhage (aSAH) from a ruptured aneurysm. Vasospasm potentially leads to delayed cerebral ischemia, and despite medical treatment, 1 of 3 patients suffer a persistent neurological deficit. Bedside transcranial Doppler (TCD) ultrasonography is used to indirectly detect CV through recognition of an increase in cerebral blood flow velocity (CBFV). The present study aimed to use TCD ultrasonography to monitor how CBFV changes on both the ipsi- and contralateral sides of the brain in the first 24 hours after patients have received a stellate ganglion block (SGB) to treat CV that persists despite maximum standard therapy.METHODSThe data were culled from records of patients treated between 2013 and 2017. Patients were included if an SGB was administered following aSAH, whose CBFV was ≥ 120 cm/sec and who had either a focal neurological deficit or reduced consciousness despite having received medical treatment and blood pressure management. The SGB was performed on the side where the highest CBFV had been recorded with 8–10 ml ropivacaine 0.2%. The patient’s CBFV was reassessed after 2 and 24 hours.RESULTSThirty-seven patients (male/female ratio 18:19), age 17–70 years (mean age 49.9 ± 11.1), who harbored 13 clipped and 22 coiled aneurysms (1 patient received both a coil and a clip, and 3 patients had 3 untreated aneurysms) had at least one SGB. Patients received up to 4 SGBs, and thus the study comprised a total of 76 SGBs.After the first SGB, CBFV decreased in 80.5% of patients after 2 hours, from a mean of 160.3 ± 28.2 cm/sec to 127.5 ± 34.3 cm/sec (p < 0.001), and it further decreased in 63.4% after 24 hours to 137.2 ± 38.2 cm/sec (p = 0.007). A similar significant effect was found for the subsequent SGB. Adding clonidine showed no significant effect on either the onset or the duration of the SGB. Contralateral middle cerebral artery (MCA) blood flow was not reduced by the SGB.CONCLUSIONSTo the authors’ knowledge, this is the largest study on the effects of administering an SGB to aSAH patients after aneurysm rupture. The data showed a significant reduction in ipsilateral CBFV (MCA 20.5%) after SGB, lasting in about two-thirds of cases for over 24 hours with no major complications resulting from the SGB.

Sign in / Sign up

Export Citation Format

Share Document