Clinical Advances

Research progress on stellate ganglion block improving postoperative cognitive dysfunction

  • Ruyue XUE ,
  • Yuexian LI ,
  • Defeng. SUN
Expand
  • Department of Anesthesiology,the First Affiliated Hospital of Dalian Medical University,Dalian 116011,China

Received date: 2024-02-04

  Online published: 2024-06-13

Abstract

Postoperative cognitive dysfunction (POCD) is a common complication affecting elderly patients after anaesthesia. It is characterised by acute or persistent impairments of attention, learning and memory after surgery. This cognitive disorder can lead not only to an increase in postoperative complications and prolonged hospital stays, but also to an increased societal burden and waste of medical resources. Stellate ganglion block (SGB) is a commonly used nerve block technique in clinical practice. It works to block neural signals from stellate ganglion to control pain or treat certain conditions primarily by injecting local anaesthetics. This article summarises the mechanisms by which SGB improves POCD, focusing on the regulation of cerebral vasculature, oxidative stress and inflammatory responses. It aims to provide elderly patients with an approach to safer and more effective postoperative recovery and seek new therapies to alleviate the burden of POCD.

Cite this article

Ruyue XUE , Yuexian LI , Defeng. SUN . Research progress on stellate ganglion block improving postoperative cognitive dysfunction[J]. The Journal of Practical Medicine, 2024 , 40(11) : 1500 -1504 . DOI: 10.3969/j.issn.1006-5725.2024.11.006

References

1 TRAVICA N, LOTFALIANY M, MARRIOTT A, et al. Peri-Operative Risk Factors Associated with Post-Operative Cognitive Dysfunction (POCD): An Umbrella Review of Meta-Analyses of Observational Studies [J]. J Clin Med, 2023, 12(4):1610. doi:10.3390/jcm12041610
2 DENG X, SUN T, ZHAO D, et al. Stellate ganglion block potentially ameliorates postoperative cognitive decline in aged rats by regulating the neuroendocrine response to stress [J]. Heliyon, 2023, 9(3):e14337. doi:10.1016/j.heliyon.2023.e14337
3 YU K, ZHANG X K, XIONG H C, et al. Stellate ganglion block alleviates postoperative cognitive dysfunction via inhibiting TLR4/NF-κB signaling pathway [J]. Neurosci Lett, 2023, 807:137259. doi:10.1016/j.neulet.2023.137259
4 PENG W, LU W, JIANG X, et al. Current Progress on Neuroinflammation-mediated Postoperative Cognitive Dysfunction: An Update [J]. Curr Mol Med, 2023, 23(10):1077-1086. doi:10.2174/1566524023666221118140523
5 LU J, LIU Z, ZHAO Y, et al. FGF19 improves sevoflurane-induced cognitive dysfunction in rats through the PGC-1α/BDNF/FNDC5 pathway [J]. Tissue Cell, 2023, 81:102012. doi:10.1016/j.tice.2022.102012
6 BOWDEN T, HURT C S, SANDERS J, et al. Predictors of cognitive dysfunction after cardiac surgery: a systematic review [J]. Eur J Cardiovasc Nurs, 2022, 21(3):192-204. doi:10.1093/eurjcn/zvab086
7 YANG X, HUANG X, LI M, et al. Identification of individuals at risk for postoperative cognitive dysfunction (POCD) [J]. Ther Adv Neurol Disord, 2022, 15:17562864221114356. doi:10.1177/17562864221114356
8 WU Y, ZHANG Y, YUAN X, et al. Influence of education level on MMSE and MoCA scores of elderly inpatients [J]. Appl Neuropsychol Adult, 2023, 30(4):414-418. doi:10.1080/23279095.2021.1952588
9 LIANG J, HAN S, YE C, et al. Minocycline Attenuates Sevoflurane-Induced Postoperative Cognitive Dysfunction in Aged Mice by Suppressing Hippocampal Apoptosis and the Notch Signaling Pathway-Mediated Neuroinflammation [J]. Brain Sci, 2023, 13(3):512. doi:10.3390/brainsci13030512
10 ZHANG L, LI X, YAO J, et al. Ultrasound-guided stellate ganglion block: A visual teaching method [J]. Asian J Surg, 2022, 45(8):1596-1597. doi:10.1016/j.asjsur.2022.03.034
11 LIU Y, ZHANG L, SUN Y, et al. Efficacy and safety of stellate ganglion block with different volumes of ropivacaine to improve sleep quality in patients with insomnia: a comparative study [J]. Eur Rev Med Pharmacol Sci, 2023, 27(21):10233-10239.
12 SHAN H H, CHEN H F, NI Y, et al. Effects of Stellate Ganglion Block Through Different Approaches Under Guidance of Ultrasound [J]. Front Surg, 2021, 8:797793. doi:10.3389/fsurg.2021.797793
13 丁飞, 王勇, 吴哲乾, 等. miR-24-3p对脑缺血再灌注导致的神经元损伤的影响及机制研究 [J]. 解剖科学进展, 2023, 29(6):618-622.
14 SAMAGH N, PANDA N B, GUPTA V, et al. Impact of Stellate Ganglion Block in the Management of Cerebral Vasospasm: A Prospective Interventional Study [J]. Neurol India, 2022, 70(1):289-295. doi:10.4103/0028-3886.338735
15 DAVIS J, OZCAN M S, KAMDAR J K, et al. Stellate ganglion block used to treat reversible cerebral vasoconstriction syndrome [J]. Reg Anesth Pain Med, 2021, 46(8):732-734.
16 SHI Z M, JING J J, XUE Z J, et al. Stellate ganglion block ameliorated central post-stroke pain with comorbid anxiety and depression through inhibiting HIF-1α/NLRP3 signaling following thalamic hemorrhagic stroke [J]. J Neuroinflammation, 2023, 20(1):82. doi:10.1186/s12974-023-02765-2
17 HILDENBORG M, K?HLIN J, GRANATH F, et al. The Neuroimmune Response to Surgery - An Exploratory Study of Trauma-Induced Changes in Innate Immunity and Heart Rate Variability [J]. Front Immunol, 2022, 13:911744. doi:10.3389/fimmu.2022.911744
18 FISCHER L, BAROP H, LUDIN S M, et al. Regulation of acute reflectory hyperinflammation in viral and other diseases by means of stellate ganglion block. A conceptual view with a focus on Covid-19 [J]. Auton Neurosci, 2022, 237:102903. doi:10.1016/j.autneu.2021.102903
19 BANKS W A, RHEA E M. The Blood-Brain Barrier, Oxidative Stress, and Insulin Resistance [J]. Antioxidants (Basel), 2021, 10(11):1695. doi:10.3390/antiox10111695
20 TORO-PéREZ J, RODRIGO R. Contribution of oxidative stress in the mechanisms of postoperative complications and multiple organ dysfunction syndrome [J]. Redox Rep, 2021, 26(1):35-44. doi:10.1080/13510002.2021.1891808
21 ZHOU C, LI M, CHU Y, et al. Stellate ganglion block suppresses hippocampal ferroptosis to attenuate cerebral ischemia-reperfusion injury via the Hippo pathway [J]. Metab Brain Dis, 2023, 38(5):1633-1642. doi:10.1007/s11011-023-01196-5
22 BELL T, FRANZ C E, KREMEN W S. Persistence of pain and cognitive impairment in older adults [J]. J Am Geriatr Soc, 2022, 70(2):449-458. doi:10.1111/jgs.17542
23 盛韵如, 王宁燕, 张学康, 等. 超声引导下星状神经节阻滞对剖宫产产妇焦虑、术后疼痛及泌乳素的影响 [J]. 中国计划生育学杂志, 2023, 31(9):2040-2043+2048.
24 MARQUAND K, ROSELLI C, CERVANTES-SANDOVAL I, et al. Sleep benefits different stages of memory in Drosophila [J]. Front Physiol, 2023, 14:1087025. doi:10.3389/fphys.2023.1087025
25 WEN Y, XU J, SHEN J, et al. Esketamine Prevents Postoperative Emotional and Cognitive Dysfunction by Suppressing Microglial M1 Polarization and Regulating the BDNF-TrkB Pathway in Ageing Rats with Preoperative Sleep Disturbance [J]. Mol Neurobiol, 2024.doi: 10.1007/s12035-023-03860-4 .
26 POTES Y, CACHáN-VEGA C, ANTU?A E, et al. Benefits of the Neurogenic Potential of Melatonin for Treating Neurological and Neuropsychiatric Disorders [J]. Int J Mol Sci, 2023, 24(5):4803. doi:10.3390/ijms24054803
27 FENG Y, CHANG P, LIU J, et al. Effects and mechanisms of perioperative medications on the hypothalamic pituitary adrenal response to surgical injury: A narrative review [J]. J Clin Anesth, 2024, 94:111367. doi:10.1016/j.jclinane.2023.111367
28 DAI D, ZHENG B, YU Z, et al. Right stellate ganglion block improves learning and memory dysfunction and hippocampal injury in rats with sleep deprivation [J]. BMC Anesthesiol, 2021, 21(1):272. doi:10.1186/s12871-021-01486-4
29 苏圣贤. 连续星状神经节阻滞对颅内动脉瘤介入术后脑血管痉挛预防及对血浆褪黑素、内皮素-1的影响 [J]. 蚌埠医学院学报, 2023, 48(2):214-216+221.
30 AKDIS C A. Does the epithelial barrier hypothesis explain the increase in allergy, autoimmunity and other chronic conditions? [J]. Nat Rev Immunol, 2021, 21(11):739-751. doi:10.1038/s41577-021-00538-7
31 KINASHI Y, HASE K. Partners in Leaky Gut Syndrome: Intestinal Dysbiosis and Autoimmunity [J]. Front Immunol, 2021, 12:673708. doi:10.3389/fimmu.2021.673708
32 ZHU G, KANG Z, CHEN Y, et al. Ultrasound-guided stellate ganglion block alleviates stress responses and promotes recovery of gastrointestinal function in patients [J]. Dig Liver Dis, 2021, 53(5):581-586. doi:10.1016/j.dld.2020.11.028
Outlines

/