Effects of stellate ganglion block on postoperative cognitive dysfunction in elderly patients undergoing radical resection of gastrointestinal malignancy

Objective To investigate the effects of stellate ganglion block (SGB) on postoperative cognition dysfunction (POCD) in elderly patients undergoing radical resection for gastrointestinal malignancy.

Methods Fifty patients undergoing radical resection of gastrointestinal tract malignant tumor were randomly divided into SGB group and control group, and 40 patients completed the study finally, with 20 cases in each group. All patients in two groups received general anesthesia combined with epidural anesthesia, and SGB group received SGB before surgery. Heart rate (HR) and mean arterial pressure (MAP) in two groups before general anesthesia induction (t₀), immediately after tracheal intubation (t₁), at the beginning of surgery (t₂), 1 h after surgery (t₃), 2 h after surgery (t₄), at the end of surgery (t₅), immediately after extubation (t₆), and at 30 min (t₇) when entering the anesthesia recovery room (PACU) were observed. Changes of electrolytes and blood glucose were observed at t₀, t₃, t₄ and t₅. Plasma interleukin(IL)-1, IL-6, IL-10 and S100β concentrations were recorded at 24 h before (T₀), 24 h after surgery (T₁) and 72 h after surgery (T₃). Cognitive function was assessed at T₀, T₁, T₃, 5 d after operation (T₄) and 7 d after operation (T₅) using the Mini‐Mental State Examination(MMSE).

Results HR at t₇ in the SGB group was lower than that at t₀, t₁ and t₆, and MAP and HR at t₁, t₂ and t₆ in the SGB group were lower than those in the control group (P < 0.05). There were no significant differences in serum potassium, calcium and lactic acid levels between the SGB group and the control group at each time point (P>0.05). Blood glucose levels at t₄ and t₅ in the SGB group were lower than those in the control group, the differences were statistically significant (P < 0.05). The levels of IL-6 at T₁, IL-1 at T₂ and S100β protein at T₁ and T₂ in the SGB group were lower than those in the control group, while the level of IL-10 at T₂ was higher than those in control group (P < 0.05). At T₁ and T₂, the MMSE score of the SGB group was higher than that of the control group, and the incidence of POCD was lower than that of the control group (P < 0.05).

Conclusion SGB improves postoperative cognitive function and decreases the incidence of POCD in elderly patients undergoing radical resection for gastrointestinal malignancy.