A randomized controlled study of ultrasound-guided stellate ganglion block in patients with neurocritical gastrointestinal dysfunction

CHENG Gang; ZHANG Shiyuan; JIA Lu; SONG Lu; GUO Yuhong; LIU Xiaojun; LI Xiaodong; HUO Yuqi; YANG Xiaochen; LI Xiaojie; GAO Haiyan; WANG Xiaoyu; MA Jiuhong; ZHANG Xiufeng

doi:10.3639/j.issn.1671-2897.2025.04.013

Abstract：Objective To explore the effect of stellate ganglion block under ultrasound guidance on patients with severe neurological gastrointestinal dysfunction.Methods Forty patients with neurocritical gastrointestinal dysfunction(Acute Physiology and Chronic Health Evaluation Ⅱ score≥15 points;those meeting the diagnosis of acute gastrointestinal injury grade Ⅱ and Ⅲ)admitted to Shanxi Provincial People's Hospital from April 2024 to November 2024 were selected as the research objects.The patients were divided into the stellate ganglion block(SGB)group and the control group by the random number table method,with 20 patients in each group.In the SGB group,SGB operation was performed at the level of the sixth cervical vertebra under ultrasound guidance,and 10 mL of 1%lidocaine was injected.In the control group,10 mL of 0.9%sodium chloride solution was injected by percutaneous puncture under ultrasound guidance at the same site for 5 consecutive days.Fasting venous blood was collected at admission and 5 days after treatment.The concentrations of plasma tumor necrosis factor-α(TNF-α),interleukin(IL)-6,and IL-10 were measured by enzyme-linked immunosorbent assay.At the same time,indicators such as white blood cell count and C-reactive protein(CRP)were measured,and the recovery time of bowel sounds,the time of anal exhaust,intra-abdominal pressure(IAH),and the length of stay in the intensive care unit(ICU)were recorded.Results In the SGB group,the levels of plasma TNF-α,IL-6,white blood cell count,and CRP decreased more significantly compared with the control group,while the level of IL-10 increased more significantly.In the SGB group,the recovery time of bowel sounds and the time of anal exhaust were earlier than those in the control group,the intra-abdominal pressure was lower,and the length of stay in the ICU was shortened.Conclusion Ultrasound-guided percutaneous stellate ganglion block(SGB)can reduce the inflammatory response in patients with severe neurological diseases,lower the intra-abdominal pressure,promote the recovery of gastrointestinal function,and accelerate the recovery of these patients.