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Stellate ganglion block inhibits formalin-induced nociceptive responses: mechanism of action

Published online by Cambridge University Press:  25 November 2005

Q. X. Wang ,
X. Y. Wang ,
N. A. Fu ,
J. Y. Liu  and
S. L. Yao
Q. X. Wang
Affiliation:
People's Hospital, P. R. China Huazhong University of Science and Technology Tongji Medical School, Union Hospital, Department of Anesthesiology, Wuhan, P. R. China
X. Y. Wang
Affiliation:
Taihe Hospital, Yunyang Medical College, Department of Anesthesiology, Shiyan, P. R. China
N. A. Fu
Affiliation:
Taihe Hospital, Yunyang Medical College, Department of Anesthesiology, Shiyan, P. R. China
J. Y. Liu
Affiliation:
Taihe Hospital, Yunyang Medical College, Department of Anesthesiology, Shiyan, P. R. China
S. L. Yao
Affiliation:
Huazhong University of Science and Technology Tongji Medical School, Union Hospital, Department of Anesthesiology, Wuhan, P. R. China
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Extract

Summary

Background and objective: Stellate ganglion block has been extensively used in clinical practice for the management of painful conditions such as cephalic, facial and upper limb pains yet its mechanism of action and its analgesic efficacy are poorly understood. Method: Formalin (3% 0.2 mL) was injected into the plantar region of the right upper limb paw in rabbits and 50 min after this injection, saline or bupivacaine 2.5% 0.5 mL was administered via a chronic implantation catheter near the right stellate ganglion. Behavioural modification, changes in heart rate and plasma norepinephrine release at different time points after formalin and bupivacaine or saline injection were observed. Finally, the cervical spinal cord was harvested and immunostaining for substance P and c-Fos was performed. Results: Formalin caused stress noxious behavioural changes and a significant increase in heart rate and norepinephrine release. These changes were inhibited by bupivacaine stellate ganglion block but not by saline injection. Immunoreactants of substance P were significantly decreased by formalin injection compared with that in controls. However, with bupivacaine injection, substance P levels were restored though not reaching the levels seen in the controls. Formalin injection also caused a significant increase of c-Fos expression in cervical spinal cord. This increase was not affected by stellate ganglion block. Conclusion: Stellate ganglion block can effectively alleviate nociceptive responses induced by formalin injection. The mechanism of its action may involve reduction of substance P in the spinal cord and plasma catecholamine release caused by noxious stimuli.

Keywords

ANAESTHETIC TECHNIQUE, stellate ganglion blockRABBITLOCAL ANAESTHETICS, bupivacaineCATECHOLAMINES, norepinephrineSUBSTANCE P
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 22 , Issue 12 , December 2005 , pp. 913 - 918
Copyright
© 2005 European Society of Anaesthesiology

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