Haemodynamic effects of a left stellate ganglion block in ASA I patients. An echocardiographic study

In anaesthetized dogs, stellate ganglion blockade led to a moderate disturb ance in left ventricular diastolic function. We investigated the effect of a left-sided block, following injection of 10 mL bupivacaine 0.5%, on echoc ardiographic variables of ventricular function in eight otherwise healthy p atients with sympathetically mediated pain syndromes. After the blockade, h eart rate (control: 66 +/- 3 (mean +/- SEM), block: 64 +/- 3 min(-1)) and m ean arterial blood pressure (88.5 +/- 6.0 vs. 84.0 +/- 8.1 mmHg) were uncha nged, but afterload decreased (end-systolic meridional wall stress; 69.6 +/ - 9.9 vs. 59.8 +/- 7.1, P < 0.05). Stroke volume increased from 71.2 +/- 8. 1 to 79.6 +/- 7.4 mL, P < 0.05. Variables of systolic function were unchang ed, but relaxation was prolonged (isovolumic relaxation time; 71 +/- 5 vs. 81 +/- 4 ms, P < 0.05). In patients who were ASA I, there was a small impai rment in echocardiographic variables during ventricular relaxation after a left stellate ganglion blockade. This small effect did not compromise ventr icular function, and the heart responded with a small stroke volume increas e to the simultaneous afterload reduction.