Stellate Ganglion Block
Conditions
Keywords
Delirium, Cognitive Dysfunction, Sleep Disorders
Brief summary
Postoperative delirium is an acute state of confusion, which is characterized by changes in attention and cognitive functions and fluctuations in consciousness; postoperative cognitive dysfunction is a common central nervous system complication in elderly patients after surgery, often manifested as memory, Obstacles in abstract thinking and orientation are accompanied by a decline in social activity ability. Postoperative delirium and cognitive dysfunction can prolong hospital stay, increase medical expenses, affect postoperative functional recovery, and even increase postoperative mortality. Sleep disorders are a group of diseases that affect the ability to sleep well regularly and cause severe impairment of social and occupational functions. Stellate ganglion block is a selective sympathetic ganglion block, in which a local anesthetic is injected into the loose connective tissue of the neck including the stellate ganglion. There are complex connections between stellate ganglia and multiple brain regions in the brain, which can improve postoperative delirium, cognitive function and sleep disturbance to a certain extent, and have certain guiding significance for postoperative rehabilitation of elderly patients.
Interventions
PROCEDUREStellate ganglion block
Find the position of the stellate ganglion under ultrasound guidance, and inject 0.375% ropivacaine near the stellate ganglion to block the sympathetic nerves in the upper chest and head and neck
Sponsors
Yangzhou University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
65 Years to 85 Years
Healthy volunteers
No
Inclusion criteria
1. Age ≥ 60 years; 2. ASA grade I-III; 3. Operative time ≥ 2 h for laparoscopic radical resection of a suspected; gastrointestinal malignancy.
Exclusion criteria
: 1. Patient's lack of consent to participate; 2. Known allergy to anesthetic drugs; 3. History of psychiatric or neurological disease(s); 4. Long-term use of opioids or sedative-hypnotic drugs; 5. Previous or planned neurosurgical procedures; 6. contraindications to epidural anesthesia; 7. Hearing or visual impairment that precludes scale assessment.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Changes in the level of Mini-Men-tal State Examination scale score | The day before surgery and 1,2,3,5,7 days after surgery | Assess the cognitive function of the patient by asking questions on the patient scale |
| Changes in the level of actigraphy | The 1st night before the operation and the 1st, 2nd and 3rd nights postoperatively | Through the actigraphy, monitor the patient's sleep quality |
| Changes in the level of Pittsburgh sleep quality index | The day before surgery and 1,2,3,5,7 days | Assess the patient's sleep quality by asking questions on the scale |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Changes in the level of IL-10 | Preoperative, 6 am on the first day after surgery, 6 am on the third day after surgery | The outcome above should be measured at the time Preoperative, 6 am on the first day after surgery, 6 am on the third day after surgery |
| Changes in the level of IL-6 | Preoperative, 6 am on the first day after surgery, 6 am on the third day after surgery | The outcome above should be measured at the time Preoperative, 6 am on the first day after surgery, 6 am on the third day after surgery |
| Changes in the level of Melatonin | Preoperative, 6 am on the first day after surgery, 6 am on the third day after surgery | The outcome above should be measured at the time Preoperative, 6 am on the first day after surgery, 6 am on the third day after surgery |
| Changes in the level of IL-1 | Preoperative, 6 am on the first day after surgery, 6 am on the third day after surgery | The outcome above should be measured at the time Preoperative, 6 am on the first day after surgery, 6 am on the third day after surgery |
| Changes in the level of Oxygen saturation | Baseline (Before induction), immediately before intubation, immediately after intubation, at the beginning of the operation, 1 hour after the beginning of the operation, and immediately after extubation at the end of the operation | The outcome above should be measured at the time Before induction, immediately before intubation, immediately after intubation, at the beginning of the operation, 1 hour after the beginning of the operation, and immediately after extubation at the end of the operation |
| Changes in the value and waveform of Narcotrend | Baseline (Before induction), immediately before intubation, immediately after intubation, at the beginning of the operation, 1 hour after the beginning of the operation, and immediately after extubation at the end of the operation | The outcome above should be measured at the time Before induction, immediately before intubation, immediately after intubation, at the beginning of the operation, 1 hour after the beginning of the operation, and immediately after extubation at the end of the operation |
| Changes in the level of S100-β | Preoperative, 6 am on the first day after surgery, 6 am on the third day after surgery | The outcome above should be measured at the time Preoperative, 6 am on the first day after surgery, 6 am on the third day after surgery |
| Changes in the level of Heart Rate | Baseline (Before induction), immediately before intubation, immediately after intubation, at the beginning of the operation, 1 hour after the beginning of the operation, and immediately after extubation at the end of the operation | The outcome above should be measured at the time Before induction, immediately before intubation, immediately after intubation, at the beginning of the operation, 1 hour after the beginning of the operation, and immediately after extubation at the end of the operation |
| Changes in the level of Systolic Blood Pressure/Diastolic Blood Pressure(Mean Arterial Pressure) | Baseline (Before induction), immediately before intubation, immediately after intubation, at the beginning of the operation, 1 hour after the beginning of the operation, and immediately after extubation at the end of the operation | The outcome above should be measured at the time Before induction, immediately before intubation, immediately after intubation, at the beginning of the operation, 1 hour after the beginning of the operation, and immediately after extubation at the end of the operation |
| Local cerebral Oxygen Saturation | Collected every 15 minutes before induction of anesthesia to 1 hour after the end of anesthesia | The outcome above should be measured Local cerebral oxygen saturation meter |
Countries
China
Outcome results
None listed