Clinical Study of Stellate Ganglion Block Combined with General Anesthesia on Hemodynamics, Cognitive Function, and Gastrointestinal Function in Elderly Patients Undergoing Partial Hepatectomy

Chen, Wen; Baohua, Chen; Wu, Qingsong; Liu, Wenying; Hong, Wei; Li, Changke

doi:10.1155/2021/1426753

Cited by 10 publications

(13 citation statements)

References 26 publications

(26 reference statements)

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“…Five trials not fulfilling the inclusion criteria were excluded after full-text screening (online supplemental table 1). Twenty-six RCTs enrolling 4414 patients with a mean age of 70.69 years were included in this systematic review and meta-analysis 25–50. Of these, 2251 patients were enrolled in the RAB group, and 2163 were assigned to the control group.…”

Section: Resultsmentioning

confidence: 99%

“…The incidence of PONV was significantly reduced with the usage of RAB (OR 0.59: 95% CI 0.46 to 0.77; p<0.0001; I 2 =0%; Tau 2 =0.00) (online supplemental figure 16). Among the other adverse effects, constipation was reported in four trials,33 37 42 43 pruritus,28 30 31 and atelectasis28 31 43 in three trials each, and respiratory depression25 29 and urinary retention36 43 in two trials each.…”

Section: Resultsmentioning

confidence: 99%

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Role of supplemental regional blocks on postoperative neurocognitive dysfunction after major non-cardiac surgeries: a systematic review and meta-analysis of randomized controlled trials

Singh

Makkar

Borle

et al. 2022

Reg Anesth Pain Med

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Background/importancePostoperative neurocognitive dysfunction (PNCD) is a frequent and preventable complication after surgery. The large high-quality evidence for the efficacy of supplemental regional analgesia blocks (RAB) for preventing PNCD is still elusive.ObjectiveThe objective of this meta-analysis was to evaluate the effect of RAB versus standard anesthesia care on the incidence of PNCD in adult patients undergoing major non-cardiac surgery.Evidence reviewPubMed, EMBASE, Scopus, and the Cochrane Central Registers of Controlled Trials (CENTRAL) were searched for randomized controlled trials (RCTs) from 2017 until June 2022. The primary outcome was the incidence of PNCD within 1 month of surgery. A random-effects model with an inverse variance method was used to pool results, and OR and mean differences were calculated for dichotomous and continuous outcomes. Various exploratory subgroup analyses were performed to explore the possibility of the association between the various patient, technique, and surgery-related factors. Grading of Recommendation, Assessment, Development, and Evaluation guidelines were used to determine the certainty of evidence.FindingsTwenty-six RCTs comprizing 4414 patients were included. The RAB group was associated with a significant reduction in the incidence of PNCD with an OR of 0.46 (95% CI 0.35 to 0.59; p<0.00001; I2=28%) compared with the control group (moderate certainty). Subgroup analysis exhibited that the prophylactic efficacy of RAB persisted for both delirium and delayed neurocognitive recovery.ConclusionsCurrent evidence suggests that supplemental RAB are beneficial in preventing PNCD in patients after major non-cardiac surgery.PROSPERO registration numberCRD42022338820

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Role of supplemental regional blocks on postoperative neurocognitive dysfunction after major non-cardiac surgeries: a systematic review and meta-analysis of randomized controlled trials

Singh

Makkar

Borle

et al. 2022

Reg Anesth Pain Med

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“…Among these, 1182 records were eliminated due to duplication, and 495 records were further excluded basing on the screening of titles and abstracts. Finally, 9 RCTs met our inclusion criteria [11][12][13][14][15][16][17][18]. The study selection process is illustrated in Fig.…”

Section: Study Identi Cation and Characteristicsmentioning

confidence: 99%

Efficacy of ultrasound-guided stellate ganglion block on relieving acute postoperative pain: systematic review and meta-analysis

Zhao

Xiao

2023

Preprint

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Background The efficacy of stellate ganglion block (SGB) in alleviating postoperative pain remains uncertain. This meta-analysis aimed to determine the efficacy of ultrasound-guided SGB in relieving acute postoperative pain in patients undergoing surgery with general anesthesia. Methods A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted comparing SGB with control or placebo. The primary outcome was pain score at 24h after surgery. Secondly outcomes included postoperative pain scores at other times (0, 2, 4, 6, 8, 12h) and postoperative nausea and vomiting. A random effects model was used to calculate mean difference (MD) or risk ratio (RR) with 95% confidence intervals. Results Eight studies, with a total of 470 patients, were included in this meta-analysis. Ultrasound-guided SGB was associated with lower pain score at 24h after surgery (MD − 0.71; 95% CI: −1.26, − 0.16, p = 0.01, I2 = 86%), with low level of evidence. Ultrasound-guided SGB was also linked to a lower pain score at postoperative 8h (MD − 0.65; 95% CI: −1.03, − 0.28, p = 0.01, I2 = 29%), with moderate level of evidence. There was no difference in pain scores at 0, 2, 4, 6,12 hours after surgery. Conclusion Ultrasound-guided SGB is effective in alleviating acute postoperative pain. However, given the low level of evidence and a limited number of trials, more large-scale and high-quality RCTs are required in the future researches.

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“…As various bodily functions of elderly people decline to varying degrees with the increase of age, the risks they bear during surgery are signi cantly higher than those of other age groups [8] . Sternum reduction and xation as a bone surgery with invasive surgical operation, mainly used for repair trauma fractures of the chest rib fracture, and need to be carried out under the premise of general anesthesia surgery, but because of the particularity of narcotic drugs and the vulnerability of the elderly, easy to cause cognitive dysfunction after surgery, in ammation aggravate or neurological disorders such as poor prognosis, It is usually manifested by impaired memory, aggravated anxiety, personality change, etc., which seriously threatens the prognosis and quality of life of elderly patients [9][10] . Therefore, it is of great signi cance to explore a general anesthesia method that can not only effectively maintain the depth and length of anesthesia sedation during surgery, but also reduce the stress response of the body, thus reducing the damage to neurological and cognitive functions, for improving the prognosis of elderly patients [11] .…”

Section: Related Workmentioning

confidence: 99%

Effects of TIVA and VICA on cognitive function, oxidative stress level and postoperative adverse reactions in elderly patients during sternum reduction and fixation

Cheng

et al. 2022

Preprint

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Backgroud: The effect of general anesthesia during the reduction and fixation of the sternum by TIVA method on the degree of cognitive impairment in the elderly. Methods: Research main way prepared through a prospectie, aged 60 or more in our line of sternum, reduction and fixation of 78 cases of elderly patients were randomly divided into all by intravenous anesthesia (TIVA) combined with intravenous inhalation group anesthesia (VICA) group, and observed in patients with different anesthetic methods on oxidative stress related indicators, the influence of postoperative cognitive function and adverse reaction. Results: As can be seen from the results by different methods of anesthesia operation time, blood loss and postoperative open time had no obvious effect, but different anesthetic methods on cognitive function in patients with and oxidative stress are different degrees of influence, embodied in the MoCA scale after evaluation, different ways of anesthesia will cognitive function in patients with damage to a certain extent, However, TIVA had significantly lower cognitive impairment than VICA and recovered faster in a short time. The comparison of oxidative stress related indexes showed that the oxidative stress level of each group increased sharply at the beginning of surgery due to external invasion, and then decreased with the end of surgery, and the oxidative stress level of TIVA group was lower than that of VICA group after surgery. The kaplan-Meier survival curve showed that the incidence of postoperative adverse reactions in TIVA group was significantly lower than that in VICA group. Conclusion: Therefore, this study further demonstrated that TIVA method for general anesthesia during sternum reduction and fixation in the elderly is more conducive to reducing the degree of cognitive impairment, reducing the level of intraoperative oxidative stress and postoperative adverse reactions, which has high clinical application value.

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Clinical Study of Stellate Ganglion Block Combined with General Anesthesia on Hemodynamics, Cognitive Function, and Gastrointestinal Function in Elderly Patients Undergoing Partial Hepatectomy

Cited by 10 publications

References 26 publications

Role of supplemental regional blocks on postoperative neurocognitive dysfunction after major non-cardiac surgeries: a systematic review and meta-analysis of randomized controlled trials

Role of supplemental regional blocks on postoperative neurocognitive dysfunction after major non-cardiac surgeries: a systematic review and meta-analysis of randomized controlled trials

Efficacy of ultrasound-guided stellate ganglion block on relieving acute postoperative pain: systematic review and meta-analysis

Effects of TIVA and VICA on cognitive function, oxidative stress level and postoperative adverse reactions in elderly patients during sternum reduction and fixation

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