Ultrasound-guided Stellate Ganglion Block Improves Gastrointestinal Function After Thoracolumbar Spinal Surgery
Ultrasound-guided Stellate Ganglion Block Improves Gastrointestinal Function After Thoracolumbar Spinal Surgery
复制标题
超声引导星状神经节阻滞改善胸腰椎手术后的胃肠功能
DOI：
10.1016/j.clinthera.2017.09.008
复制
发表时间：
2017-11-01
影响因子：
3.2
通讯作者：
Ji, Fu-hai
中科院分区：
文献类型：
--
作者：
Peng, Ke;Zhang, Juan;Ji, Fu-hai
目的：本研究的目的是探讨星状神经节阻滞（SGB）对胸腰椎后路手术后胃肠功能的影响。方法：40例胸腰椎骨折患者随机分为两组：超声引导下SGB组和假手术组（对照组）。诱导后，分别注射6 mL 1%利多卡因或0.9%生理盐水进行超声引导SGB（n = 20）或假手术（n = 20）。主要结果为术后胃肠功能，包括肠鸣音听诊、腹胀发生率和程度、排气时间和麻痹性肠梗阻。与假手术组（对照组）相比，SGB组患者的胃肠道功能更好，术后24小时和36小时的肠鸣音更规则（80% vs 40%，P = 0.024，95% vs 60%，P 0.023），腹胀较少（10% vs 45%，P = 0.034），排气时间略短（平均值[SD]，12.0 [4.4] vs 14.7 [4.6]小时，P = 0.068）。基于正常肠鸣音的生存分析发现两组之间存在显著差异（P = 0.004）。SGB术后患者满意度较高（85%vs45%，P = 0.020）。没有术后肠梗阻或mortality occurred.Implications：在这项初步研究中，超声引导SGB加速了胃肠道转运的恢复，减轻了肠道症状，提高了胸腰椎脊柱手术后患者的满意度。(C)出版社：Elsevier HS Journals，Inc.
Purpose: The purpose of this study was to investigate the effects of stellate ganglion block (SGB) on gastrointestinal function after thoracolumbar spinal surgery.Methods: Forty patients with thoracolumbar fracture scheduled for posterior spinal surgery were randomly assigned to 2 groups: ultrasound-guided SGB or sham (control group). After induction, ultrasound-guided SGB (n = 20) or a sham procedure (n = 20) was conducted with a 6-mL injection of 1% lidocaine or 0.9% saline, respectively. Primary outcomes were postoperative gastrointestinal function, including auscultation of bowel sounds, incidence and degree of abdominal bloating, flatus time, and paralytic ileus.Findings: Patients in the SGB group had better gastrointestinal function compared with those in the sham (control) group, as indicated by more regular bowel sounds at 24 and 36 hours postoperatively (80% vs 40%, P = 0.024, and 95% vs 60%, P 0.023), lesser abdominal bloating (10% vs 45%, P = 0.034), and slightly shorter flatus time (mean [SD], 12.0 [4.4] vs 14.7 [4.6] hours, P = 0.068). Survival analysis based on regular bowel sounds found a significant difference between the 2 groups (P = 0.004). In addition, more patients had higher satisfaction after SGB (85% vs 45%, P = 0.020). No postoperative ileus or mortality occurred.Implications: In this preliminary study, ultrasound guided SGB accelerated the return of gastrointestinal transit, alleviated bowel symptoms, and improved patient satisfaction after thoracolumbar spinal surgery. (C) 2017 Published by Elsevier HS Journals, Inc.