Effects of Stellate Ganglion Block Combined with General Anesthesia on Postoperative Cognitive Function and Inflammatory Factors in Elderly Patients Undergoing Hepatectomy for Liver Cancer
ZHANG Tingting
LIU Junjie
DING Panpan
WANG Xin
WANG Zicheng
HE Wensheng
Abstract：Objective To observe the effects of stellate ganglion block(SGB)combined with general anesthesia on postoperative cognitive function and inflammatory factors in elderly patients undergoing hepatectomy for liver cancer.Methods A total of 114 elderly patients scheduled for liver cancer resection at the Second People's Hospital of Hefei between January 2023 and December 2024 were selected and randomly divided into an SGB group(n=57)and a control group(n=57)using a random number table.The SGB group received SGB combined with general anesthesia,while the control group received general anesthesia alone.The following parameters were compared between the two groups:visual analog scale(VAS)pain scores at 2,6,24,and 48 hours postoperatively;intraoperative consumption of anesthetics(propofol and remifentanil);number of postoperative patient-controlled analgesia(PCA)boluses;rescue analgesia rate;Mini-Mental State Examination(MMSE)scores at 1 day before surgery and 1 day and 7 days after surgery;incidence of POCD within 7 days after surgery;cerebral oxygen extraction ratio(CERO2)at 5 minutes after entering the operating room,30 minutes after surgery began,and at the end of surgery;serum levels of interleukin-6(IL-6)and interleukin-1β(IL-1β)at 1 hour before surgery and 24 hours after surgery;and adverse reactions within 48 hours after surgery.Results Compared with the control group,the SGB group had significantly lower VAS scores at 2,6,and 24 hours after surgery(P<0.05),reduced intraoperative remifentanil consumption,fewer PCA boluses(P<0.05),and a lower rescue analgesia rate(P<0.05).The MMSE scores of the SGB group were higher than those of the control group at 1 day and 7 days after surgery(P<0.05).The incidence of POCD within 7 days after surgery was 15.79%in the SGB group,which was significantly lower than that in the control group(31.58%,P<0.05).At 30 minutes after the start of surgery and at the end of surgery,CERO2 increased in both groups(P<0.05),but were lower in the SGB group than in the control group(P<0.05).At 24 hours after surgery,serum IL-6 and IL-1β levels were elevated in both groups compared with preoperative levels(P<0.05),but were lower in the SGB group than in the control group(P<0.05).The total incidence of adverse reactions within 48 hours after surgery was 8.77%in the SGB group,significantly lower than that in the control group(22.81%,P<0.05).Conclusion SGB combined with general anesthesia not only enhances postoperative analgesia but also improves cognitive function and reduces the incidence of POCD in elderly patients undergoing liver cancer resection.The underlying mechanism may be related to improved cerebral oxygen metabolism and suppression of inflammatory responses.
Keywords：postoperative cognitive dysfunctionliver cancerresectionstellate ganglion blockinflammatory response
Publication Date：2025-09-20
Online Publishing Date：2025-09-29(First online date of this platform, not the publication date of the document)
Pages：5( 152-156 )