Right sided stellate ganglion block before pneumoperitoneum in laparoscopic surgeries. Does it balance Hemodynamics? A case series

Abstract

The laparoscopic technique is currently used for many types of surgery because it is painless, has less nociceptive stimulus from the skin and tissues, has fewer wound complications, and allows for a faster and smoother postoperative recovery. Institution of capnoperitoneum to visualize the viscera inside is the need in these cases. However, capnoperitoneum can cause many side effects including a significant rise in heart rate and blood pressure. Stellate ganglion block (SGB) is a sympathetic block for the head, neck, chest, and upper limbs. Hence, we hypothesized that blocking the same, especially right-sided, will decrease a sympathetic surge after capnoperitoneum. We conducted three such cases with administration of ultrasound-guided SGB in the right side 10 min before capnoperitoneum and found that there was no surge in hemodynamics. We postulate that right-sided SGB can be added to the armamentarium of countless techniques to blunt the response. We admit that this is a very small primitive report with only three cases. As ultrasound was used in all the cases, the deposition of local anesthetic drug was precise.