左侧神经节阻滞用于19例冠心病冠脉搭桥术患者效果观察

目的探讨左侧星状神经节阻滞（SGB）对冠心病冠脉搭桥术患者术中血浆内皮素、皮质醇、去甲肾上腺素的影响。方法将38例拟行冠状动脉搭桥术患者随机分为星状神经节阻滞组（SGB组）和对照组,分别用1％利多卡因和生理盐水10ml行左侧SGB,患者入室后局麻下放入Swan-Ganz导管,分别于入室后（T0）,SGB后5min（T1）、10min（T2）、15min（T3）,麻醉诱导气管插管即刻（T4）,切皮即刻（T5）和劈胸骨即刻（T6）各时间点抽静脉血分离血浆,放免法测血浆内皮素（ET）、去甲肾上腺素（NE）、皮质醇（COR）水平。结果SGB组SGB后10、15min血浆ET、NE显著降低（P〈0．05）;COR亦有下降趋势,但麻醉前后比较和两组间比较无统计学差异。结论单次左侧SGB对冠心病患者血浆ET、NE、COR改变有明显调节作用。

Effect of left stellate ganglion block on the coronary artery bridging surgery in patients with coronary disease

Objective To investigate the effects of left stellate ganglion block on plasma endothelin （ET）, norepinephrine（NE） and cortisol（COR） on conditions of coronary artery bridging surgery（CABG） in patients with coronary disease. Methods Thirty eight ASA Ⅱ or Ⅲ patients scheduled for CABG were enrolled in this study. The patients were randomly divided into Stellate ganglion block （SGB） group and control group. They were performed SGB by injection 10 ml 1% lidocaine or normal saline respectively. Plasma ET, NE and COR were determined before SGB（TO）, 5,10 and 15min after SGB （ T1, T2, T3 ） , after anaesthesia induction （ T4 ） , after incision （ T5 ） , breaks out the breastbone （T6） respectively. Restilts The plasma ET, NE at T2 and T3 in goup SGB decreaed compared with that in the control group （P 〈 0. 05 ）. Plasma COR decreased too with no significant difference. Conclusion A single left SGB can decrease level of ET,NE in patients with coronary disease.