Effects of ultrasound guided ganglion stellate blockade on intraoperative and postoperative hemodynamic responses in laparoscopic gynecologic surgery

Abstract BackgroundAtelectasis is a major cause of hypoxemia during general anesthesia and postoperative pulmonary complications (PPCs).Some previous reported that the combined use of lung recruitment procedures (LRMs) and positive end-expiratory pressure (PEEP) in mechanical ventilation mode contributes to the avoidance of PPCs in patients after general anesthesia, while others suggest that the use of LRMs makes patients more susceptible to hemodynamic disturbances and lung injury, and is of limited potential to decrease the incidence of PPCs. From this perspective, controversy exists as to whether LRMs should be routinely applied to surgical patients. More importantly, corresponding clinical studies are also lacking. Therefore, this trial was conducted with the aim of solving the above problem.MethodsIn current clinical trial, patients undergoing laparoscopic gynecologic surgery with healthy lungs were randomized to the recruitment maneuvers group (RM group; 6 cm H2O PEEP and RMs) and the control group (C group; 6 cm H2O PEEP and no RMs). Lung ultrasound was performed on patients at five separate time points. During mechanical ventilation, patients in the RM group received ultrasound-guided pulmonary resuscitation when atelectasis was detected, while the C group did not intervene. Lung ultrasound scores were used to evaluate the incidence and severity of atelectasis.ResultsAfter LRMs, the incidence of atelectasis was significantly lower in the RM group (40%) than in the C group (80%) 15 minutes after arrival in the post-anesthesia care unit (PACU), and this difference did not persist for 24 hours after surgery. Meanwhile, postoperative pulmonary complications showed no difference between the two groups.ConclusionsThe combination of LRMs and PEEP decreased the incidence of atelectasis 15 minutes after admission to the PACU, but did not improve PPCs in adults with healthy lungs. Hence, for lung-healthy patients undergoing gynecological laparoscopic surgery, we do not recommend routine recruitment maneuvers. Trial registration: (prospectively registered): ChiCTR2000033529. Registered on 6/4/2020.

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Evaluation of ultrasound-guided posterior quadratus lumborum block for postoperative analgesia after laparoscopic gynecologic surgery

Journal of Clinical Anesthesia ◽

10.1016/j.jclinane.2017.05.015 ◽

2017 ◽

Vol 41 ◽

pp. 1-4 ◽

Cited By ~ 34

Author(s):

Junichi Ishio ◽

Nobuyasu Komasawa ◽

Haruki Kido ◽

Toshiaki Minami

Keyword(s):

Postoperative Analgesia ◽

Gynecologic Surgery ◽

Ultrasound Guided ◽

Quadratus Lumborum Block ◽

Quadratus Lumborum ◽

Laparoscopic Gynecologic Surgery

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Postoperative Analgesic Effects of Ultrasound-Guided Bilateral Rectus Sheath Block for Laparoscopic Gynecologic Surgery

Journal of Minimally Invasive Gynecology ◽

10.1016/j.jmig.2014.08.531 ◽

2014 ◽

Vol 21 (6) ◽

pp. S157

Author(s):

S. Cho ◽

S.Y. Park ◽

Y.J. Kim ◽

K. Jeong

Keyword(s):

Rectus Sheath ◽

Gynecologic Surgery ◽

Ultrasound Guided ◽

Analgesic Effects ◽

Rectus Sheath Block ◽

Laparoscopic Gynecologic Surgery

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Effect of Ultrasound-guided Lung Recruitment Maneuvers on Atelectasis in Lung-healthy Patients Undergoing Laparoscopic Gynecologic Surgery: a Randomized Controlled Trial

10.21203/rs.3.rs-995493/v1 ◽

2021 ◽

Author(s):

Yi Liu ◽

Jingyu Wang ◽

Yong Wan ◽

Yuan Geng ◽

Yiran Zhang ◽

...

Keyword(s):

Mechanical Ventilation ◽

General Anesthesia ◽

Lung Ultrasound ◽

Pulmonary Complications ◽

Lung Recruitment ◽

Gynecologic Surgery ◽

Postoperative Pulmonary Complications ◽

Ultrasound Guided ◽

Recruitment Maneuvers ◽

Laparoscopic Gynecologic Surgery

Abstract BackgroundAtelectasis is a major cause of hypoxemia during general anesthesia and postoperative pulmonary complications (PPCs).Some previous reported that the combined use of lung recruitment procedures (LRMs) and positive end-expiratory pressure (PEEP) in mechanical ventilation mode contributes to the avoidance of PPCs in patients after general anesthesia, while others suggest that the use of LRMs makes patients more susceptible to hemodynamic disturbances and lung injury, and is of limited potential to decrease the incidence of PPCs. From this perspective, controversy exists as to whether LRMs should be routinely applied to surgical patients. More importantly, corresponding clinical studies are also lacking. Therefore, this trial was conducted with the aim of solving the above problem.MethodsIn current clinical trial, patients undergoing laparoscopic gynecologic surgery with healthy lungs were randomized to the recruitment maneuvers group (RM group; 6 cm H2O PEEP and RMs) and the control group (C group; 6 cm H2O PEEP and no RMs). Lung ultrasound was performed on patients at five separate time points. During mechanical ventilation, patients in the RM group received ultrasound-guided pulmonary resuscitation when atelectasis was detected, while the C group did not intervene. Lung ultrasound scores were used to evaluate the incidence and severity of atelectasis.ResultsAfter LRMs, the incidence of atelectasis was significantly lower in the RM group (40%) than in the C group (80%) 15 minutes after arrival in the post-anesthesia care unit (PACU), and this difference did not persist for 24 hours after surgery. Meanwhile, postoperative pulmonary complications showed no difference between the two groups.ConclusionsThe combination of LRMs and PEEP decreased the incidence of atelectasis 15 minutes after admission to the PACU, but did not improve PPCs in adults with healthy lungs. Hence, for lung-healthy patients undergoing gynecological laparoscopic surgery, we do not recommend routine recruitment maneuvers. Trial registration (prospectively registered)ChiCTR2000033529. Registered on June 4, 2020.

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