scholarly journals The Effect of a Combined Modified Pectoral and Stellate Ganglion Block on Stress and Inflammatory Response in Patients Undergoing Modified Radical

2021 ◽  
Author(s):  
Jun Geng ◽  
Jing Wang ◽  
Yaowen Zhang ◽  
Wenxiang Song ◽  
Junjia Zhu ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Inflammatory Responses ◽  
Stellate Ganglion ◽  
Stellate Ganglion Block ◽  
Radical Mastectomy ◽  
Control Group ◽  
Modified Radical Mastectomy ◽  
Ultrasound Guided ◽  
Ganglion Block ◽  
Pain Scores

Abstract Background: Surgical resection is the primary and most effective method for removing breast tumors, but it is associated with significant stress and inflammatory responses. Previous studies have indicated that these responses can be influenced by anesthetic method. While regional anesthesia has been shown to attenuate stress and inflammatory responses associated with surgical procedure, the effectiveness of combined nerve blocks has not been investigated. Therefore, we conducted this study to evaluate whether the combination of a pectoral nerve block (PNB) and stellate ganglion block (SGB) is more effective than a PNB alone in reducing stress and inflammatory responses in women undergoing modified radical mastectomy.Methods: A total of 50 breast cancer patients with American Society of Anesthesiologists physical status I or II were enrolled and randomly allocated to receive either a (1) preoperative ultrasound-guided PNB (20 mL of 0.375% ropivacaine) only (control group, n = 25) or (2) ultrasound-guided PNB (20 mL of 0.375% ropivacaine) combined with a SGB (5 mL of 0.15% ropivacaine) (SGB group, n = 25). The primary outcome was neuroendocrine levels at different time points during the 72-hour postoperative period. Assessed neuroendocrine variables included cortisol, glucose, interleukin (IL)-6, interleukin (IL)-8, and tumor necrosis factor (TNF)-a. Secondary outcomes included pain scores, hemodynamic variables, sleep quality on the night of surgery, and side effects after surgery.Results: A total of 50 patients completed the study. Cortisol levels were significantly lower in the SGB group compared to the control group at the end of the surgery. Glucose levels at the time of incision were lower in the SGB group than in the control group. The SGB group exhibited significantly lower IL-6 and TNF-a levels compared to the control group at 24 hours post-surgery. There was no significant difference in perioperative IL-10 levels between the two groups. Pain scores up to 12 hours postoperatively were significantly lower in the SGB group, which also exhibited better perioperative hemodynamic stability. Patients in the SGB group reported a better sleep quality on the night of the operation than those in the control group. No side effects were observed in either group.Conclusions: In patients undergoing a modified radical mastectomy, the combination of a SGB and PNB can more effectively blunt perioperative stress and inflammatory responses, as well as postoperative acute pain, compared to a PNB alone. A combined block approach also results in more stable perioperative hemodynamics and a better postoperative sleep quality.

Evaluation of the Clinical Effect of Color Doppler Ultrasound-Guided Stellate Ganglion Block Combined with Drugs in the Treatment of Cervical Headache

2021 ◽  
Vol 11 (3) ◽  
pp. 938-947
Author(s):  
Qian Yu ◽  
Enrui Zheng ◽  
Xiuju Ding
Keyword(s):  
Doppler Ultrasound ◽  
Clinical Effect ◽  
Color Doppler ◽  
Stellate Ganglion ◽  
Stellate Ganglion Block ◽  
Color Doppler Ultrasound ◽  
Control Group ◽  
Observation Group ◽  
Ultrasound Guided ◽  
Ganglion Block

In order to evaluate the clinical effect of color Doppler ultrasound-guided stellate ganglion block combined with drugs in the treatment of cervical headache, a total of 80 patients, who were diagnosed as cervical headache at the hospital designated by this study from December 2017 to December 2018, were selected as study subjects, and were divided into 2 groups of control group and observation group according to random number table method with 40 cases in each group. The control group was treated only with drugs: 0.3 mg gabapentin orally taken 3 times a day, 0.3 mg tizanidine hydrochloride orally taken 3 times a day, and 0.2 mg celecoxib orally taken 3 times a day for a total of 4 continuous weeks; the observation group was treated with ultrasound-guided stellate ganglion block based on the scheme of control group. The degree of patients’ pain was evaluated by visual analogue scale (VAS), which was divided into 0–10 points; the clinical efficacy evaluation was divided into three levels: markedly effective, effective and ineffective. The results showed that the total effective rate of patients’ treatments in observation group was 92.50%, which was significantly higher than that of 72.50% in the control group with statistically significant difference (P < 0.05); there was no statistical difference of patients’ average VAS score between the two groups before the treatment (P > 0.05), while the average VAS score of patients in the observation group after treatment (3.58±1.46) was significantly lower than that in the control group (5.37±1.58) with statistically significant difference (P < 0.05); and there were no serious adverse reactions in both groups. Therefore, it is believed that color Doppler ultrasound-guided stellate ganglion block combined with oral gabapentin, tizanidine hydrochloride, and celecoxib is effective in treating cervical headache. The study results of this paper provides a certain reference for further evaluations of the clinical effect of color Doppler ultrasound-guided stellate ganglion block combined with drugs in the treatment of cervical headache.

scholarly journals Prospective Study: The Analgesic Efficacy of Ultrasound-Guided Erector Spinae Plane Block versus Serratus Plane Block in Patients Undergoing Modified Radical Mastectomy

2021 ◽  
pp. 9-18
Author(s):  
Martina Farag Wahba Mekhaeil ◽  
Ayman Abd Elmaksod Yousef ◽  
Hesham Mohammed Marof ◽  
Shaimaa Farouk Abdelkader
Keyword(s):  
Radical Mastectomy ◽  
Analgesic Efficacy ◽  
Erector Spinae ◽  
Control Group ◽  
Modified Radical Mastectomy ◽  
Ultrasound Guided ◽  
Serratus Anterior ◽  
Group Iii ◽  
Erector Spinae Plane Block ◽  
Group I

Background: Breast Cancer is the most commonly occurring cancer affecting ‎women undergoing modified radical mastectomy, causing acute pain, and in ‎high percentage of patients it progresses to chronic pain syndromes. The Erector Spinae Plane Block (ESPB) ‎and Serratus Anterior Plane Block (SAPB) are options of regional anesthesia that can produce reliable ‎analgesia. In this study we aimed to evaluate the analgesic efficacy of ‎ultrasound guided ESPB and SAPB in patients underwent modified radical ‎mastectomy operation. Patients and Methods: Patients were randomly classified using computer generated numbers ‎concealed in ‎ sealed opaque envelopes into three equal groups; 30 patients ‎were enrolled in each group. ‎Group I: Control Group (C): Patients received intravenous (IV) systemic analgesia only, Group II: ESPB group: Patients received ‎ipsilateral ultrasound guided ESPB using 20 ml bupivacaine 0.25% at the ‎level of the 4th thoracic segment (T4). and Group III: SPB group: Patients received ipsilateral ‎serratus plane block using 30 ml bupivacaine 0.25% at the level of the 5th rib.‎ Results: In this study, 113 patients were assessed for eligibility, 16 patients ‎did not meet the criteria and 7 patients refused to participate in the study. ‎The remaining 90 patients were randomly allocated into three groups (30 ‎patients in each). All patients (90) were followed-up and analyzed ‎statistically‎. Conclusion: Ultrasound-guided SAPB and ESPB provided effective post-‎operative analgesia in patients undergoing modified radical mastectomy with ‎lower pain scores, less peri operative analgesic consumption and longer ‎duration of analgesia in SAPB.

scholarly journals Magnesium Sulfate as an Adjuvant in Ultrasound Guided Stellate Ganglion Block for Post Mastectomy Pain Syndrome

2021 ◽  
Vol 89 (6) ◽  
pp. 975-985
Author(s):  
GHADA F. AL-RAHMAWY, M.D.; ENAS A. ABD AL-MOTELEB, M.D. ◽  
MONA G. EL-EBEIDY, M.D.; MOHAMED A. HAFEZ, M.Sc.
Keyword(s):  
Magnesium Sulfate ◽  
Stellate Ganglion ◽  
Stellate Ganglion Block ◽  
Pain Syndrome ◽  
Ultrasound Guided ◽  
Ganglion Block

THE POSTOPERATIVE RADICAL-MASTECTOMY SYNDROME ITS TREATMENT WITH STELLATE GANGLION BLOCK

1959 ◽  
Vol 3 (1) ◽  
pp. 120???124
Author(s):  
D. C. MOORE ◽  
L. D. BRIDENBAUGH ◽  
J. W. BAKER ◽  
C. S. STONE ◽  
PAUL DUMKE
Keyword(s):  
Stellate Ganglion ◽  
Stellate Ganglion Block ◽  
Radical Mastectomy ◽  
Ganglion Block

Blood Flow in Common Carotid and Vertebral Arteries in Patients with Sudden Deafness

1997 ◽  
Vol 106 (1) ◽  
pp. 27-32 ◽  
Author(s):  
Yoshimitsu Ohinata ◽  
Shin-Ichi Haginomori ◽  
Kazuo Makimoto ◽  
Michitoshi Araki ◽  
Michiro Kawakami ◽  
...  
Keyword(s):  
Blood Flow ◽  
Stellate Ganglion ◽  
Stellate Ganglion Block ◽  
Sudden Deafness ◽  
Control Group ◽  
Ganglion Block ◽  
Male Patients ◽  
The Common ◽  
Normal Adults ◽  
Carotid And Vertebral Arteries

Blood flow was measured in the common carotid artery (CCA) and the vertebral artery (VA) by the ultrasonic Doppler method in 14 male patients with sudden deafness and 70 normal adults. In the patients, blood flow on the affected side was slower than that on the normal side or that of the control group. Although these differences were not statistically significant in the CCA or in the VA, significant differences in the blood flow were noted between the group with a hearing loss of greater than 50 dB and the group with a loss of less than 50 dB. A negative correlation was found between blood viscosity and blood flow in both CCAs and both VAs. After stellate ganglion block (SGB), the blood flow of the CCA and VA increased on the side of the SGB and decreased on the opposite side. The changes in blood flow after SGB decreased with age, presumably because of changes in the blood vessel walls and a weaker response to sympathetic nerve receptors in the arterial wall.

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