Ultrasound-guided the stellate ganglion block relieved the stress responses and improved early postoperative sleep in elderly patients after thoracoscopic surgery for lung cancer

Background: Thoracoscopic surgery is one of the main methods for the treatment of lung cancer. Most patients had severe sleep disorders after surgery, which affected the rapid recovery of patients. Postoperative sleep disturbance may be associated with strong stress responses. Our study was to evaluate the effects of stellate ganglion block (SGB) on stress responses and early postoperative sleep for the aging with lung cancer after thoracoscopic surgery. Methods: : 92 eligible elderly people were included and randomly divided into the SGB group and control group. Before anesthesia induction, The patients in SGB group were given 0.5% ropivacaine 7ml to the stellate ganglion site , while scanned the stellate ganglion block site in the control group. We needed to monitor the sleep duration, N3 sleep stage and sleep efficiency index by BIS-Vista monitor at various time points. We also needed to recorded AIS score, VAS score, the concentration of cortisol, norepinephrine and 6-HMS at various time points. Results: : Most of patients had insomnia after surgery in the both groups , but compared with the control group, patients in the SGB group showed longer sleep duration and N3 stage sleep, higher sleep efficiency index, lower AIS score, and higher concentration of 6-hydroxysulfate melatonin in urina sanguinis. In addition, the SGB treatment inhibited HPA and SAM axis, alleviated stress responses. And patients in the SGB group had lower concentration of cortisol and norepinephrine after surgery. Conclusions: : The SGB treatment relieved the stress responses and improved the early postoperative sleep of elderly patients with lung cancer after thoracoscopic surgery.