Effects of Stellate Ganglion Block on the Peri-operative Vasomotor Cytokine Content and Intrapulmonary Shunt in Patients with Esophagus Cancer

Objective: To investigate the effects of stellate ganglion block (SGB) on the peri-operative vasomotor cytokinecontent and intrapulmonary shunt in patients with esophagus cancer who underwent thoracotomy. Materialsand
Methods: Forty patients undergoing elective resection of esophageal cancer patients who had Ⅰ~Ⅱ AmericanSociety of Anesthesiologist (ASA) were randomly divided into total intravenous anesthesia group (group N, n=20)and total intravenous anesthesia combined with SGB group (group S, n=20, 0.12 mL/kg 1% lidocaine was usedfor SGB 10 min before induction). Heart rate (HR), mean arterial pressure (MAP), central venous pressure(CVP), mean pulmonary arterial pressure (MPAP) and continuous cardiac output (CCO) were continuouslymonitored. The blood from internal jugular vein was drawn respectively before induction (T0), and 30 min (T1),60 min (T2) and 120 min (T3) after one-lung ventilation (OLV), and 30 min (T4) after two-lung ventilation. Thecontents of plasma endothelin (ET), nitric oxide (NO) and calcitonin gene-related peptide (CGRP) were detectedwith enzyme linked immunosorbent assay (ELISA). Meanwhile, arterial and mixed venous blood samples werecollected for determination of blood gas and calculation of intrapulmonary shunt fraction (Qs/Qt).
Results:During OLV, ET contents were increased significantly in two groups (P<0.05), and no significant difference waspresented (P>0.05). NO content in group S was obviously higher than in group N at T3 (P<0.05), whereas CGRPcontent in group N was markedly lower than in group S at each time point (P<0.05). Qs/Qt was significantlyincreased in both groups after OLV, but there was no statistical significant regarding the Qs/Qt at each time pointbetween two groups.
Conclusions: Total intravenous anesthesia combined with SGB is conducive to regulationof perioperative vasomotor cytokines in thoracotomy, and has little effect on intrapulmonary shunt at the timeof OLV.