Effects of stellate ganglion block on attention and executive function in middle-aged and elderly patients after surgery

Objective To investigate the effects of stellate ganglion block(SGB)on attention and executive function in middle-aged and elderly patients after surgery. Methods Middle-aged and elderly patients aged 55-75 years who underwent hip replacement surgery under lumbar anesthesia were randomized into a control group and an SGB group.Patients in the SGB group received ultrasound-guided stellate ganglion block 30 min before surgery, and patients in the control group were given no additional treatment before surgery.All patients were tested with a modified version of the Trail Making Test-Part A(TMT-A)and a modified version of the Symbol Digit Modalities Test(SDMT)1 day before surgery and 7 days after surgery.The Z-score method was used to diagnose postoperative attention and/or executive function impairment. Results The modified versions of TMT-A and SDMT had good reliability and validity among Chinese middle-aged and elderly people aged 55-75 years.Age was the main influencing factor for the two tests, and their two parallel versions had good alternate-form reliability.There was no significant difference between the control group and the SGB group in scores of modified TMT-A and SDMT at 7 days after surgery(P>0.1). However, the incidence of attention and/or executive function impairment was lower in the SGB group than in the control group(19.3% vs.36.6%, P<0.05). Conclusions The modified TMT-A and SDMT have good reliability and validity among Chinese middle-aged and elderly people aged 55-75 years.Preoperative SGB may protect attention and executive function in middle-aged and elderly patients. Key words: Stellate ganglion; Arthroplasty, replacement, hip; Attention; Executive function