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Abstract:

Objective To investigate the effects of stellate ganglion block on the intrapulmonary shunt， oxygenation，and early postoperative cognitive function in elderly patients during the period of one⁃lung ventilation. Methods Sixty patients，aged 65 to 80 years，who underwent thoracic surgery under general anesthesia，were randomly divided into two groups：group SGB and C（n = 30 in each group）. In group SGB，the ventilation side of one lung was injected with 0.25% ropivacaine 3ml SGB under ultrasound guided treatment before surgery. In contrast，patients in group C was not given SGB. BIS and rScO2 were recorded during general anesthesia. Blood samples from artery and internal jugular vein were taken before SGB（T0），15 min（T1）after two lung ventilation， 15 min（T2），30 min（T3），60 min（T4）after one ⁃lung ventilation and 15 min（T5）after the restoration of two lung ventilation. A formula calculated the intrapulmonary shunt（Qs/Qt）. Mini⁃mental state examination（MMSE） and Montreal Cognitive Assessment Scale（MoCA）evaluated the cognitive function at one day before and after the operation，and seven days after the operation. Postoperative cognitive dysfunction（POCD）was recorded. Results Qs/Qt was increased and PaO2 was decreased in both groups，rScO2 decreased in C group during single lung ventila⁃ tion（P < 0.05）；Qs/Qt of T2，T3，T4 in SGB group was lower than that in C group. PaO2 and rScO2 of T2 and T3 in SGB group was higher than that in C group（P < 0.05）；The MMSE and MoCA scores of SGB group were higher than those of C group 1 d and 7 d after surgery. The total incidence of POCD in SGB group was lower than that in C group（P < 0.05）. Conclusion Stellate ganglion block does not increase intrapulmonary shunt during one lung ventilation，which is beneficial to improve oxygenation and early postoperative cognitive function.

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