Effect of stellate ganglion block-guided by ultrasound on tourniquet response in knee arthroplasty

ObjectiveTo study the effects of ultrasound-guided stellate ganglion block(SGB)on tourniquet response in knee arthroplasty.

MethodsSixty patients treated with unilateral knee arthroplasty were randomly divided into the group C and group E by random number table method.The group C and group E were treated with general anesthesia and SGB guided by ultrasound combined with general anesthesia.The heart rate(HR), systolic blood pressure(SBP), blood oxygen saturation(SpO₂), EEG dual frequency index(BIS), anesthetic dosage, intraoperative blood loss, operation time, awake time, extubation time, postoperative sleep quality and postoperative complications were compared between two groups before tourniquet inflation(T₀), after 30 min(T₁)and 1 h(T₂)of tourniquet inflation, before tourniquet deflation(T₃), after 5 min(T₄)and 30 min(T₅)of tourniquet.

ResultsThe differences of the HR, SBP, SpO₂ and BIS at T₀, T₁, T₂ and T₅, the HR, SpO₂ and BIS at T₄, and the SpO₂ at T₃ were not statistically significant between two groups(P>0.05).The HR, SBP and BIS in C group at T₃ were significantly higher than those in group E(P < 0.05 to P < 0.01).The anesthetic dosage, wake-up time, extubation time and postoperative sleep quality score in group C were significantly higher than those in group E(P < 0.05), and the differences of the intraoperative blood loss and operation time between two groups were not statistically significant(P < 0.05).The incidence rates of postoperative complication in group C and group E were 10.00% and 6.67, respectively, and the difference of which was not statistically significant(P>0.05).

ConclusionsThe SGB guided by ultrasound can reduce the tourniquet response in knee replacement surgery, thereby stabilizing the patient's hemodynamics, reducing the use of intraoperative narcotic analgesics, and not increasing adverse reactions.