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ORIGINAL RESEARCH article

Front. Aging Neurosci.
Sec. Neurocognitive Aging and Behavior
Volume 17 - 2025 | doi: 10.3389/fnagi.2025.1503314
This article is part of the Research Topic The Open Challenges of Cognitive Frailty: Risk Factors, Neuropsychological Profiles and Psychometric Assessment for Healthy Aging View all 13 articles

Improved Early Postoperative Cognition in Elderly Gastrointestinal Patients: A Randomized Controlled Trial on the Role of Ultrasound-Guided Stellate Ganglion Block

Provisionally accepted
Ruyue Xue Ruyue Xue Yuexian Li Yuexian Li Mei Zhan Mei Zhan Lin Yang Lin Yang Defeng Sun Defeng Sun *
  • First Affiliated Hospital, Dalian Medical University, Dalian, China

The final, formatted version of the article will be published soon.

    Background: This study evaluates the impact of ultrasound-guided stellate ganglion block (SGB) on early postoperative cognitive dysfunction (POCD) in elderly patients who underwent laparoscopic gastrointestinal (GI) surgery, as well as its potential effect on oxidative stress and inflammatory responses.: In this randomized controlled trial, 104 elderly patients scheduled for elective laparoscopic GI surgery were randomized to receive ultrasound-guided SGB before general anesthesia (SGB group) or general anesthesia alone (control group). A total of 98 patients completed the study. Cognitive function was assessed using the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) preoperatively, and on postoperative days one and three. The perioperative recordings included mean arterial pressure, heart rate, and the bispectral index. Blood samples were analyzed for interleukin-6 (IL-6), superoxide dismutase (SOD), and malondialdehyde (MDA).The SGB group had a significantly lower incidence of POCD on postoperative day one (p<0.05). IL-6 and MDA levels were significantly lower, while SOD levels were higher in the SGB group, when compared to the control group (p<0.05). MDA levels were notably lower on postoperative day three in the SGB group (p<0.05). Both groups showed significant changes in IL-6, SOD and MDA levels, when compared to preoperative values. The hemodynamic indicators showed a slight reduction in intraoperative blood pressure and decreased numerical rating scale scores on the first postoperative day without significant differences in other indicators.Preoperative SGB reduces early POCD in elderly patients who undergo laparoscopic GI surgery, possibly through the inhibition of oxidative stress and inflammatory responses.

    Keywords: Stellate ganglion block, gastrointestinal surgery, postoperative cognitive dysfunction, Oxidative Stress, Inflammation

    Received: 28 Sep 2024; Accepted: 30 Jan 2025.

    Copyright: © 2025 Xue, Li, Zhan, Yang and Sun. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Defeng Sun, First Affiliated Hospital, Dalian Medical University, Dalian, China

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