The Korean Journal of Pain

The Korean Pain Society (대한통증학회)
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The Change in Regional Cerebral Oxygen Saturation after Stellate Ganglion Block

  • Park, Hyeon-Min (Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine) ;
  • Kim, Tae-Wan (Department of Anesthesiology and Pain Medicine, CHA Bundang Medical Center, CHA University) ;
  • Choi, Hong-Gyu (Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine) ;
  • Yoon, Kyung-Bong (Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine) ;
  • Yoon, Duck-Mi (Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine)
  • Received : 2009.12.17
  • Accepted : 2010.02.26
  • Published : 2010.06.01
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Abstract

Background: Stellate ganglion block (SGB) is known to increase blood flow to the innervations area of the stellate ganglion. Near infrared spectroscopy reflects an increased blood volume and allows continuous, non-invasive, and bedside monitoring of regional cerebral oxygen saturation ($rSO_2$). We investigated the influence of SGB on bilateral cerebral oxygenation using a near infrared spectroscopy. Methods: SGB was performed on 30 patients with 1% lidocaine 10 ml using a paratracheal technique at the C6 level and confirmed by the presence of Horner's syndrome. The blood pressure (BP), heart rate (HR) and rSO2 were measured before SGB and 5, 10, 15 and 20 minutes after SGB. Tympanic temperature of each ear was measured prior to SGB and 20 minutes after SGB. Results: The increments of the $rSO_2$ on the block side from the baseline were statistically significant at 5, 10, 15 and 20 minutes. The $rSO_2$ on the non-block side compared with the baseline, however, decreased at 15 and 20 minutes. The difference between the block and the non-block sides was significant at 15 and 20 minutes. The BP at 10, 15 and 20 minutes was increased and the HR was increased at 10 and 15 minutes. Conclusions: We observed an increment of the $rSO_2$ on the block side from the baseline; however, the $rSO_2$ on the non-block side decreased.

Keywords

References

  1. Song SO, Jo YW. Effects of the volume of local anesthetic used in stellate ganglion block on the elevation of skin temperature of ipsilateral upper extremity. Korean J Anesthesiol 1999; 37: 233-9. https://doi.org/10.4097/kjae.1999.37.2.233
  2. Seo YS, Kim SH, Hur CR, Lee KJ, Lee SY, Kim CH, et al. Changes in blood flow velocity of middle cerebral artery after stellate ganglion block. Korean J Pain 1996; 9: 57-62.
  3. Patel PM, Drummond JC. Cerebral physiology and the effects of anesthetics and techniques. In: Miller's anesthesia. 6th ed. Edited by Miller RD. Philadelphia, Churchill Livingstone Publishers. 2005, pp 813-20.
  4. Umeyama T, Kugimiya T, Ogawa T, Kandori Y, Ishizuka A, Hanaoka K. Changes in cerebral blood flow estimated after stellate ganglion block by single photon emission computed tomography. J Auton Nerv Syst 1995; 50: 339-46. https://doi.org/10.1016/0165-1838(94)00105-S
  5. Okubo Y, Ogata H. Brain blood volume measured with near infrared spectroscopy increased after stellate ganglion block. Masui 1995; 44: 423-7.
  6. Mahla ME, Susan B, Cucchiara RF. Neurologic monitoring. In: Miller's anesthesia. 6th ed. Edited by Miller RD. Philadelphia, Churchill Livingstone Publishers. 2005, pp 1540-2.
  7. Olsen KS, Svendsen LB, Larsen FS. Validation of transcranial near-infrared spectroscopy for evaluation of cerebral blood flow autoregulation. J Neurosurg Anesthesiol 1996; 8: 280-5. https://doi.org/10.1097/00008506-199610000-00004
  8. Henson LC, Calalang C, Temp JA, Ward DS. Accuracy of a cerebral oximeter in healthy volunteers under conditions of isocapnic hypoxia. Anesthesiology 1998; 88: 58-65. https://doi.org/10.1097/00000542-199801000-00011
  9. Stevens RA, Stotz A, Kao TC, Powar M, Burgess S, Kleinman B. The relative increase in skin temperature after stellate ganglion block is predictive of a complete sympathectomy of the hand. Reg Anesth Pain Med 1998; 23: 266-70.
  10. Lee HK, Chung SY, Yang SK, Lee HJ, Suh YS, Kim C. Minimal volume of local anesthetic for successful stellate ganglion block. Korean J Pain 1995; 8: 60-4.
  11. Gupta MM, Bithal PK, Dash HH, Chaturvedi A, Mahajan RP. Effects of stellate ganglion block on cerebral haemodynamics as assessed by transcranial Doppler ultrasonography. Br J Anaesth 2005; 95: 669-73. https://doi.org/10.1093/bja/aei230
  12. Nitahara K, Dan K. Blood flow velocity changes in carotid and vertebral arteries with stellate ganglion block: measurement by magnetic resonance imaging using a direct bolus tracking method. Reg Anesth Pain Med 1998; 23: 600-4.
  13. Jobsis FF. Noninvasive, infrared monitoring of cerebral and myocardial oxygen sufficiency and circulatory parameters. Science 1977; 198: 1264-7. https://doi.org/10.1126/science.929199
  14. Dujovny M, Ausman JI, Stoddart H, Slavin KV, Lewis GD, Widman R. Somanetics INVOS 3100 cerebral oximeter. Neurosurgery 1995; 37: 160.
  15. McCormick PW, Stewart M, Goetting MG, Dujovny M, Lewis G, Ausman JI. Noninvasive cerebral optical spectroscopy for monitoring cerebral oxygen delivery and hemodynamics. Crit Care Med 1991; 19: 89-97. https://doi.org/10.1097/00003246-199101000-00020
  16. Williams IM, Picton A, Farrell A, Mead GE, Mortimer AJ, McCollum CN. Light-reflective cerebral oximetry and jugular bulb venous oxygen saturation during carotid endarterectomy. Br J Surg 1994; 81: 1291-5. https://doi.org/10.1002/bjs.1800810911
  17. Slavin KV, Dujovny M, Ausman JI, Hernandez G, Luer M, Stoddart H. Clinical experience with transcranial cerebral oximetry. Surg Neurol 1994; 42: 531-9. https://doi.org/10.1016/0090-3019(94)90084-1
  18. Lee YS, Kwon TM, In JY, Woo SH, Yon JH, Kim JW, et al. Reliability of $rSO_{2}$ to measure $CO_{2}$ reactivity of cerebral vasculatures during desflurane and $N_{2}O$ anesthesia. Korean J Anesthesiol 2002; 43: 288-93. https://doi.org/10.4097/kjae.2002.43.3.288
  19. Duncan LA, Ruckley CV, Wildsmith JA. Cerebral oximetry: a useful monitor during carotid artery surgery. Anaesthesia 1995; 50: 1041-5. https://doi.org/10.1111/j.1365-2044.1995.tb05947.x
  20. Daubeney PE, Pilkington SN, Janke E, Charlton GA, Smith DC, Webber SA. Cerebral oxygenation measured by near Infrared spectroscopy: comparison with jugular bulb oximetry. Ann Thorac Surg 1996; 61: 930-4. https://doi.org/10.1016/0003-4975(95)01186-2
  21. Norris EJ. Anesthesia for vascular surgery. In: Miller's anesthesia. 7th ed. Edited by Miller RD. Philadelphia, Churchill Livingstone Publishers. 2009, pp 2030-1.
  22. Kimura T, Nishiwaki K, Yokota S, Komatsu T, Shimada Y. Severe hypertension after stellate ganglion block. Br J Anaesth 2005; 94: 840-2. https://doi.org/10.1093/bja/aei134
  23. Goh JS, Min BW, Kim HD. Blood pressure, pulse rate and temperature changes of the ipsilateral upper extremity after unilateral stellate ganglion block. Korean J Pain 1990; 3: 27-33.
  24. Murakawa K, Noma K, Ishida K, Matsuda M, Maeda S, Nishimura M, et al. Changes of tympanic temperature by stellate ganglion block. Masui 1995; 44: 824-7.

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