STELLATE GANGLION BLOCK IS ASSOCIATED WITH INCREASED TIBIAL NERVE MUSCLE SYMPATHETIC ACTIVITY IN HUMANS

Citation
T. Ikeda et al., STELLATE GANGLION BLOCK IS ASSOCIATED WITH INCREASED TIBIAL NERVE MUSCLE SYMPATHETIC ACTIVITY IN HUMANS, Anesthesiology, 84(4), 1996, pp. 843-850
Citations number
14
Categorie Soggetti
Anesthesiology
Journal title
ISSN journal
00033022
Volume
84
Issue
4
Year of publication
1996
Pages
843 - 850
Database
ISI
SICI code
0003-3022(1996)84:4<843:SGBIAW>2.0.ZU;2-F
Abstract
Background: Left stellate ganglion block has been shown to increase he art rate and blood pressure, possible because of blockade of afferent vagal fibers from arterial baroreceptors in the aortic arch. Because e fferent muscle sympathetic nerve activity (MSNA) is influenced by the arterial baroreflex, the hypothesis that left stellate ganglion block increases efferent MSNA recorded from the tibial nerve of humans was t ested. Methods: Twenty healthy male volunteers were sequentially assig ned to one of three groups: stellate ganglion block (n = 10), in which 7 ml 1% mepivacaine was injected into the left stellate ganglion; pla cebo (n = 5), in which 7 ml of saline was injected into the left stell ate ganglion; and intramuscular injection (n = 5), in which 7 ml mepiv acaine was injected into the left deltoid muscle. Direct intraneural m icroneurographic recording with a tungsten microelectrode was used to record MSNA in the left tibial nerve. MSNA, heart rate, and blood pres sure were recorded before and after Injection in all groups. An additi onal five volunteers were studied with transthoracic echocardiography to examine the effect of stellate ganglion block on preload changes. R esults: Tibial nerve MSNA increased after mepivacaine injection to the left stellate ganglion but was unchanged after saline injection to th e left stellate ganglion or mepivacaine injection into the deltoid mus cle. Heart rate increased significantly after the left stellate gangli on block but did not change significantly after saline injection to th e left stellate ganglion or after mepivacaine injection to the deltoid muscle. Systemic blood pressure did not change significantly in all g roups. Left ventricular end-diastolic area and left ventricular end-di astolic circumference did not change after stellate ganglion block. Co nclusions: Tibial nerve MSNA increased during left stellate ganglion b lock with mepivacaine.