성상신경절차단으로 유발된 혈액학적 변화 및 임상증상

Abstract

Background: Stellate ganglion block (SGB) is the most common nerve block procedure in pain clinics. To evaluate changes iti the hemodynamics and peripheral blood flow on the affected extremity after SGB，SGB was performed unilaterally one at a time on the right and left stellate ganglions by injecting 1% mepivacaine 10 ml without epinephrine in a designated healthy man. Methods: SGB was repeated 16 times in one subject (right side SGB: 8, left side SGB: 8) by the same clinician. The mean arterial pressure (MAP), heart rate (HR), cardiac index (CI), systemic vascular resistance index (SVRI) and peripheral blood flow were measured in the supine position before (control), and 3, 6, 9, 12，and 15 minutes after SGB using thoracic electrical bioimpedence (Bioz system A-10043, Cardiodynamics, USA), sphygomanometer，and flow meter. Results: The values after SGB including MAP, HR, CI, and SVRI increased slightly compared to the control value. However, peripheral blood flow increased significantly (p < 0.05). The SGB did not affect systematic hemodynamics and the comparison between left and right SGB in hemodynamic changes were not clinically significant. Following SGB, ptosis (100%), nasal stiffness (100%), skin temperature elevation (100%), hoarseness (100%), numbness (81%), dizziness (25%), and swallowing difficulty (25%) were observed. Conclusions: We concluded that SGB showed to be a hemodynamically safe clinical technique. (Korean J Anesthesiol 2000; 38: 1009-1016)