Clinical Effects of Different Concentrations of Ropivacaine Mesylate on Stellate Ganglion Block_West China Medical Journal

Authors：

 YANGFan , JIANGPeng-fei

Department of Anesthesiology, Suining Central Hospital, Suining, Sichuan 629000, P. R. China;

Corresponding author：

Keywords：

Ropivacaine mesylate; Stellate ganglion; Nerve block

DOI：

10.7507/1002-0179.20140383

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Objective To compare the functioning time, duration, cervical vascular blood flow and adverse effects of different concentrations of ropivacaine mesylate in performing stellate ganglion block (SGB) under Doppler ultrasound. Methods A total of 240 patients (grade Ⅰ or Ⅱ classified by American Society of Anesthesiologists) aged between 23 and 62 years old ready to undergo SGB between January and April 2013 were chosen for our research. They were randomly divided into two groups with 120 patients in each. Group A and B received unilateral SGB with 7 mL of 0.239% and 0.596% ropivacaine mesylate respectively. Successful SGB was verified by Horner syndrome. The functioning time, duration, hemodynamic changes, cervical vascular blood flow and adverse effects were recorded and compared. Results Horner syndrome was observed in all patients. There was no significant difference in functioning time between the two groups (P>0.05). The duration of functioning was significantly longer in group B than that in group A (P<0.05). No significant difference was found in hemodynamic changes after SGB (P>0.05). No adverse effects were found in both groups. The blood flow of the vertebral artery and the internal carotid artery before the injection and 10 minutes after the injection were not significantly diferent (P>0.05). Conclusion SGB can be induced with 0.239% and 0.596% ropivacaine mesylate. We suggest using 0.596% ropivacaine mesylate by ultrasound-guiding because of the significantly longer functioning duration.

Citation： YANGFan, JIANGPeng-fei. Clinical Effects of Different Concentrations of Ropivacaine Mesylate on Stellate Ganglion Block. West China Medical Journal, 2014, 29(7): 1248-1251. doi: 10.7507/1002-0179.20140383 Copy

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22.	Feigl GC, Rosmarin W, Stelzl A, et al. Comparison of different injectate volumes for stellate ganglion block:an anatomic and radiologic study[J]. Reg Anesth Pain Med, 2007, 32(3):203-208.
23.	Tollision CD, Satterthwaite JR, Tollison JW. 临床疼痛学[M]. 宋文阁, 傅志俭, 主译. 济南:山东科学技术出版社, 2004:82.
24.	Jung G, Kim BS, Shin KB, et al. The optimal volume of 0.2% ropivacaine required for an ultrasound-guided stellate ganglion block[J]. Korean J Anesthesiol, 2011, 60(3):179-184.
25.	Nitahara K, Dan K. Blood flow velocity changes in carotid and vertebral arteries with stellate ganglion block:measurement by magnetic resonance imaging using a direct bolus tracking method[J]. Reg Anesth Pain Med, 1999, 23(6):600-604.
26.	徐阳平, 方苏亭, 杨功旭, 等. 星状神经节阻滞治疗椎动脉型颈椎病的效果及其机制[J]. 中国临床康复, 2004, 8(11):2008-2009.

1. Miller RD, Pardo M. Basics of anesthesia:expert consult[M]. 6 ed.Philadelphia:Elsevier Health Sciences, 2011:709.
2. Deer TR, Leong MS, Buvanendran A, et al. Comprehensive treatment of chronic pain by medical, interventional, and integrative approaches the American academy of pain medicine textbook on patient manugement[M]. New York:Springer, 2013:349-357.
3. 张晓东. 星状神经节阻滞的临床应用及相关机制研究[J]. 重庆医学, 2010, 39(19):2612-2613.
4. 金涌, 李俊, 吕雄文, 等. 甲磺酸罗哌卡因注射液的狗药代动力学研究[J]. 安徽医药, 2005, 9(1):10-12.
5. 李西宽, 焦亚奇, 刘俊田, 等. 甲磺酸罗哌卡因局麻作用的实验研究[J]. 中国药理学通报, 2004, 20(2):236-237.
6. 徐建青, 朱波, 叶铁虎, 等. 手术患者0.894% 甲磺酸罗哌卡因与0.75% 盐酸罗哌卡因硬膜外麻醉的效果[J]. 中华麻醉学杂志, 2005, 25(8):624-625.
7. 盐谷正弘. 神经阻滞图解[M]. 熊利泽, 郑恒兴, 主译. 西安:第四军医大学出版社, 2004:30.
8. Feigl G, Fuchs A, Gries M, et al. A supraomohyoidal plexus block designed to avoid complications[J]. Surg Radiol Anat, 2006, 28(4):403-408.
9. 蒋文臣, 郑宝森. 星状神经节阻滞[J]. 实用疼痛学杂志, 2007, 3(2):106-114.
10. 杨帆, 杨邦祥, 肖红, 等. 初学者超声引导下星状神经节阻滞与传统星状神经节阻滞准确性与安全性比较[J]. 中国疼痛医学杂志, 2008, 14(6):374-375.
11. Soneji N, Peng PW. Ultrasound-guided pain interventions-a review of techniques for peripheral nerves[J]. Korean J Pain, 2013, 26(2):111-124.
12. Rathmell JP. Atlas of image-guided intervention in regional anesthesia and pain medicine[M]. 2 ed. Philadelphia:Lippincott Williams & Wilkins, 2012:152-153.
13. Tafra L, Fine R, Whitworth P, et al. Prospective randomized study comparing cryo-assisted and needle-wire localization of ultrasoundvisible breast tumors[J]. Am J Surg, 2006, 192(4):462-470.
14. Nix CM, Harmon DC. Avoiding intravascular injection during ultrasound-guided stellate ganglion block[J]. Anaesthesia, 2011,66(2):134-135.
15. Rastogi S, Tripathi S. Cardiac arrest following stellate ganglion block performed under ultrasound guidance[J]. Anaesthesia, 2010, 65(10):1042.
16. 庄心良, 曾因明, 陈伯銮. 现代麻醉学[M]. 3版. 北京:人民卫生出版社, 2003:610-611.
17. Brenda A, David R, David J, et al. 实用产科麻醉[M]. 黄宇光,主译. 北京:人民卫生出版社, 2010:31.
18. 肖小华, 刘颖菊, 丁敏, 等. 甲磺酸罗哌卡因与盐酸罗哌卡因的生物等效性分析[J]. 第三军医大学学报, 2006, 28(19):1968-1970.
19. 蔡美华, 张马忠, 荣征星, 等. 甲磺酸罗哌卡因和盐酸罗哌卡因硬膜外阻滞的药代动力学特征比较[J]. 上海交通大学学报·医学版, 2011, 31(5):584-587.
20. 景胜, 吴悦维, 包晓航, 等. 0.894% 甲磺酸罗哌卡因与0.75% 盐酸罗哌卡因用于下腹部手术临床观察[J]. 重庆医学, 2007, 36(16):1600-1601.
21. 廖志敏, 张晋峰, 张兰, 等. 甲磺酸罗哌卡因与盐酸罗哌卡因用于神经阻滞麻醉的临床效果比较[J]. 四川医学, 2007, 28(10):1128-1130.
22. Feigl GC, Rosmarin W, Stelzl A, et al. Comparison of different injectate volumes for stellate ganglion block:an anatomic and radiologic study[J]. Reg Anesth Pain Med, 2007, 32(3):203-208.
23. Tollision CD, Satterthwaite JR, Tollison JW. 临床疼痛学[M]. 宋文阁, 傅志俭, 主译. 济南:山东科学技术出版社, 2004:82.
24. Jung G, Kim BS, Shin KB, et al. The optimal volume of 0.2% ropivacaine required for an ultrasound-guided stellate ganglion block[J]. Korean J Anesthesiol, 2011, 60(3):179-184.
25. Nitahara K, Dan K. Blood flow velocity changes in carotid and vertebral arteries with stellate ganglion block:measurement by magnetic resonance imaging using a direct bolus tracking method[J]. Reg Anesth Pain Med, 1999, 23(6):600-604.
26. 徐阳平, 方苏亭, 杨功旭, 等. 星状神经节阻滞治疗椎动脉型颈椎病的效果及其机制[J]. 中国临床康复, 2004, 8(11):2008-2009.

West China Medical Journal

Clinical Effects of Different Concentrations of Ropivacaine Mesylate on Stellate Ganglion Block

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