ZHANG Qi-wei,LI Hong-chao,NING Lin,et al.Clinical study on ultrasound-guided cervical vagus nerve block to prevent oculocardiac reflex[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2024,33(09):815-819.
ZHANG Qi-wei,LI Hong-chao,NING Lin,et al.Clinical study on ultrasound-guided cervical vagus nerve block to prevent oculocardiac reflex[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2024,33(09):815-819. DOI: 10.11659/jjssx.02E024017.
Clinical study on ultrasound-guided cervical vagus nerve block to prevent oculocardiac reflex
To observe the preventive effect of ultrasound-guided cervical vagus nerve block(CVB) in preventing oculocardiac reflex.
Methods
2
A total of 86 patients who underwent posterior scleral reinforcement or ophthalmectomy were recruited and randomly divided into the general anesthesia group and the composite anesthesia group.After admission, patients in the two groups underwent conventional general anesthesia induction intubation, and the composite anesthesia group received another 1% lidocaine for right CVB under ultrasound guidance.The heart rate, blood pressure, saturation of peripheral oxygen, atropine usage and surgical procedures of the two groups were recorded. Postoperative comfort degree, hoarseness and complications related to nerve block were compared between the two groups.
Results
2
Compared with the general anesthesia group, the proportion of patients using atropine and the proportion of suspending operation in the composite anesthesia group were significantly reduced (
P
<
0.05),and the incidence of oculocardiac reflex and the level of oculocardiac reflex were significantly decreased (
P
<
0.05).The incidence of hoarseness in the composite anesthesia group was higher than that in the general anesthesia group, and the difference was statistically significant (
P
<
0.05). There was no complication related to nerve block occurred in the composite anesthesia group.
Conclusion
2
In ophthalmic surgery,ultrasound-guided right CVB can safely and effectively inhibit the occurrence of oculocardiac reflex.
Chua AW, Chua MJ, Leung H,et al.Anaesthetic considerations for strabismus surgery in children and adults[J].Anaesth Intensive Care, 2020, 48(4):277-288.doi:10.1177/0310057X20937710http://dx.doi.org/10.1177/0310057X20937710.
Toyohara Y, Mito N, Nakagawa S, et al. Asystole due to oculocardiac reflex during surgical repair of an orbital blowout fracture[J]. Plast Reconstr Surg Glob Open, 2022,10(9):e4544. doi: 10.1097/GOX.0000000000004544http://dx.doi.org/10.1097/GOX.0000000000004544.
Gong WY, Yue XF, Cheng C,et al.The application of cervical vagus nerve block in the awake video-assisted thoracic surgery for bullectomy[J].Anaesth Crit Care Pain Med,2021,40(2):100823.doi:10.1016/j.accpm.2021.100823http://dx.doi.org/10.1016/j.accpm.2021.100823.
Arnold RW,Jansen S,Seelig JC,et al.Anesthetic impacts on the oculocardiac reflex: evidence from a large, observational study[J]. Clin Ophthalmol, 2021,15:973-981. doi: 10.2147/OPTH.S300860http://dx.doi.org/10.2147/OPTH.S300860.
Wujtewicz M, Twardowski P, Jasiński T, et al. Prediction of the occurrence of the oculocardiac reflex based on the assessment of heart rate variability. An observational study[J]. Ophthalmol Ther, 2022,11(5):1857-1867. doi: 10.1007/s40123-022-00549-0http://dx.doi.org/10.1007/s40123-022-00549-0.
Robbins SL, Greenberg M, Juan I. Surgical and anesthetic influences of the oculocardiac reflex in adults and children during strabismus surgery[J].Surv Ophthalmol,2024,69(2):S0039-6257(23)00087-5. doi: 10.1016/j.survophthal.2023.06.006http://dx.doi.org/10.1016/j.survophthal.2023.06.006.
Zhuang Z, Ye K, Wang D. Modified ophthalmectomy: optic nerve-sparing with hydroxyapatite prosthesis implant[J]. Asian J Surg,2023,46(8):3290-3291. doi: 10.1016/j.asjsur.202303035http://dx.doi.org/10.1016/j.asjsur.202303035.
Yan C, Zhao F, Gao S, et al. Observation of the effect of posterior scleral reinforcement combined with orthokeratology and 0.01% atropine in the treatment of congenital myopia: a case report[J].BMC Ophthalmol,2023,23(1):486. doi: 10.1186/s12886-023-03211-whttp://dx.doi.org/10.1186/s12886-023-03211-w.
Lee JH, Cheng KL,Choi YJ,et al. High-resolution imaging of neural anatomy and pathology of the neck[J]. Korean J Radiol,2017,18(1):180-193. doi: 10.3348/kjr.2017.18.1.180http://dx.doi.org/10.3348/kjr.2017.18.1.180.
Cunningham CJ, Martínez JL. The wandering nerve: positional variations of the cervical vagus nerve and neurosurgical implications[J].World Neurosurg,2021,156:105-110. doi: 10.1016/j.wneu.2021.09.090http://dx.doi.org/10.1016/j.wneu.2021.09.090.
Laucius O,Balnyt R,Petrikonis K,et al.Ultrasonography of the vagus nerve in the diagnosis of parkinson's disease[J].Parkinson's Disease, 2020,2020:2627471. doi: 10.1155/2020/2627471http://dx.doi.org/10.1155/2020/2627471.
Lu DH, Xu XX, Zhou R,et al. Ultrasound-guided stellate ganglion block benefits the postoperative recovery of patients undergoing laparoscopic colorectal surgery: a single-center, double-blinded, randomized controlled clinical trial[J].BMC Anesthesiol,2024,24(1):137. doi: 10.1186/s12871-024-02518-5http://dx.doi.org/10.1186/s12871-024-02518-5.
Uzunay NT, Mingir T, Erginoz E, et al. Comparison of laparoscopic-guided versus ultrasound-guided TAP block in laparoscopic cholecystectomy[J].Cir Cir,2024,92(2):174-180.doi: 10.24875/CIRU. 23000394http://dx.doi.org/10.24875/CIRU.23000394.
Ksine T, Romundstad L, Rosseland LA,et al.Ultrasonographic needle tip tracking for in-plane infraclavicular brachialis plexus blocks: a randomized controlled volunteer study[J].Reg Anesth Pain Med,2020,45(8):634-639. doi: 10.1136/rapm-2020-101349http://dx.doi.org/10.1136/rapm-2020-101349.
Gong WY, Zhang JY, Wang AZ,et al.The combination of paravertebral block and cervical vagus nerve block applied alone for anaesthesia of open appendectomy during COVID-19[J].Anaesth Crit Care Pain Med,2022,41(4):101091.doi:10.1016/j.accpm.2022.101091http://dx.doi.org/10.1016/j.accpm.2022.101091.
Shah S, Derryberry S, Teman N,et al.What happens in (the) vagus, stays in (the) vagus[J].Heart Surg Forum,2020,23(3):E335-E342. doi: 10.1532/hsf.3073http://dx.doi.org/10.1532/hsf.3073.