TITLE:
Different Effects of Right and Left Stellate Ganglion Block on Systolic Blood Pressure and Heart Rate
AUTHORS:
Shigeru Yokota, Chikuni Taneyama, Hiroshi Goto
KEYWORDS:
Stellate Ganglion Block; Hypertension; Hypotension; Heart Rate
JOURNAL NAME:
Open Journal of Anesthesiology,
Vol.3 No.3,
May
13,
2013
ABSTRACT:
Purpose: Whether
or not right and left stellate ganglion blocks (SGB) affect blood pressure (BP)
and heart rate (HR) differently has been controversial. The aim of this study
was to analyze BP and HR changes after large numbers of right or left SGBs. Methods: A
total of 16,404 right SGBs and 13,766 left SGBs were performed with 6 ml of 1%
mepivacaine using the
anterior paratracheal approach at C6. Changes in systolic BP and HR 30 min
after SGBs were compared to the baseline values. Results: Systolic BP decreased by 25 to 49 mmHg in 10.93% and more
than 50 mmHg in 0.67% of 16,404 right SGBs. Those percentages were
significantly higher than corresponding percentages; 8.43% and 0.49% of 13,766
left SGBs (P -49 mmHg in 5.74%
and more than 50 mmHg in 0.52% of left SGBs, and in 4.15% and 0.18% of right
SGBs (P Right
SGB caused marked reduction in HR (greater than 30 beats/min), more than left
SGB (4.22% versus 2.70%, P Conclusions: Both
right and left SGBs could produce clinically significant hypertension and hypotension, and also severe
bradycardia. However, right SGB produces a higher incidence of significant
reductions in systolic BP and HR, compared to left SGB. On the other hand, left
SGB produces a significant increase in systolic BP compared to right SGB. Those
differences likely stem from the hemispheric asymmetry in autonomic cardiovascular control.