Effects of continuous stellate ganglion block on serum thyroid hormone and cortisol levels in patients with severe brain injury
10.3760/cma.j.issn.0254-1416.2011.03.019
- VernacularTitle:连续星状神经节阻滞对重度颅脑损伤患者血清甲状腺激素及皮质醇水平的影响
- Author:
Tanguang WU
;
Jianhua LI
;
Huiying HU
;
Kaiwen CHEN
;
Bin LI
- Publication Type:Journal Article
- Keywords:
Stellate ganglion;
Nerve block;
Craniocerebral trauma;
Thyroid hormones;
Hydrocortisone
- From:
Chinese Journal of Anesthesiology
2011;31(3):334-337
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effects of continuous stellate ganglion block (SGB) on serum thyroid hormone and cortisol levels in patients with severe brain injury.Methods Eighty ASA Ⅱ or Ⅲ patients with severe brain injury aged 22-61 yr undergoing emergency craniotomy were randomly divided into 2 groups ( n = 40 each): control group (group C) received routine treatment only and continuous SGB group (group SGB) received continuous SGB with 0.2% ropivacaine besides routine treatment. SGB was performed on the operated side after induction of general anesthesia and tracheal intubation. An epidural catheter was placed. A bolus of 0.2% ropivacaine 7 ml was followed by continuous infusion of 0.2% ropivacaine at a rate of 2 ml/h. Continuous SGB was maintained for 48 h. Successful SGB was confirmed by increase in skin temperature by ≥1.5℃ behind earlobe on the operated side.Venous blood samples were obtained at 30 min before and 3 and 7 day after operation for determination of serum thyroid stimulating hormone (TSH), triiodothyronine (T3) ,thyroxine (T4) , reverse triiodothyronine(rT3) and cortisol concentrations. Glasgow prognosis score was used to evaluate the clinical results at 3 months after operation. Results Serum T4 , rT3 , TSH and cortisol concentrations were significantly lower while the serum T3 concentration was higher in the SGB group than in group C at 3 and 7 d after operation. The clinical results were significant better in SGB group than in group C according to Glasgow prognosis scores at 3 months after operation. Conclusion Continuous SGB can inhibit the stress response, and improve hypothalamus-pituitary-thyroid gland axis function and is helpful to patient's recovery from injury.
