广东医学2026，Vol.47Issue(3)：349-354,6.DOI:10.13820/j.cnki.gdyx.20253644
超声引导下星状神经节阻滞治疗期间失眠障碍患者血流动力学和心率变异性变化的动态观察
Dynamic changes in hemodynamics and heart rate variability during ultrasound-guided stellate ganglion block in patients with insomnia disorder
摘要
Abstract
Objective To evaluate the dynamic changes in hemodynamic parameters and heart rate variability(HRV)during ultrasound-guided stellate ganglion block(SGB)on either the left or right side in patients with insomnia disorder.Methods Twenty young and middle-aged participants with insomnia disorder were randomly assigned in a blinded manner to a left-sided SGB group(Group L)or a right-sided SGB group(Group R).In both groups,3 mL of 0.8％lidocaine was injected for ultrasound-guided stellate ganglion block.Hemodynamic parameters,including pulse rate(PR),mean arterial pressure(MAP),stroke volume(SV),stroke index(SI),cardiac output(CO),and systemic vascular resistance index(SVRI),were continuously recorded at baseline before SGB(T0),immediately after SGB(P1),and at 2 min(P2),4 min(P3),6 min(P4),and 8 min(P5)after the procedure.HRV parameters,including low-frequency power(LF),high-frequency power(HF),and the LF/HF ratio,were recorded before and after SGB.Sleep quality was assessed using the Pittsburgh Sleep Quality Index(PSQI)before SGB and 7 days after the procedure.Adverse events such as dizziness,nausea,vomiting,and respiratory depression were also documented.Results During SGB treatment,no significant fluctuations in hemodynamic parameters were observed in either group compared with base-line values.After SGB,MAP in Group R showed a slight decreasing trend(1.2％-2.7％),while PR in Group L de-creased modestly(0.4％-2.3％),and CO in Group L decreased by approximately 3.4％.However,these differences were not statistically significant between groups(P＞0.05).Following SGB,the LF/HF ratio tended to decrease in Group L(5.1％),whereas an increasing trend was observed in Group R(51.3％);however,the between-group difference was not statistically significant(P＞0.05).PSQI scores were significantly improved in both groups 7 days after SGB com-pared with baseline(P＜0.000 1).No adverse events,including dizziness,nausea,vomiting,respiratory depression,or hoarseness,were observed in either group.Conclusion In patients with insomnia disorder,ultrasound-guided unilater-al stellate ganglion block produces stable hemodynamic responses while modulating the balance between sympathetic and parasympathetic nervous activity,thereby improving sleep quality.This SGB technique appears safe and reliable and may be suitable for broader clinical application.关键词
失眠障碍/星状神经节阻滞/血流动力学/心率变异性Key words
insomnia disorder/stellate ganglion block/hemodynamics/heart rate variability分类
医药卫生引用本文复制引用
曾祝文,黄鸿锐,严笑,孙传雯,刘建华,应彦璐..超声引导下星状神经节阻滞治疗期间失眠障碍患者血流动力学和心率变异性变化的动态观察[J].广东医学,2026,47(3):349-354,6.基金项目
广州市科技计划项目(2024A03J0964) （2024A03J0964）
