Stellate ganglion block for sepsis-related organ dysfunction: mechanisms and clinical advances_West China Medical Journal

Authors：

WANG Linchuan ¹ , TANG Xuemei ² , XIANG Chunlin ² , WANG Yiping ² ,  WU Xiaoxiao ²

1. Department of Critical Care Medicine, Dazhou Dachuan District People’s Hospital, Dazhou, Sichuan 635000, P. R. China;
2. Center for Critical Care Medicine, Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital, Chengdu, Sichuan 610072, P. R. China;

Corresponding?author：

WU Xiaoxiao, Email: wuxiaoxiao@med.uestc.edu.cn

Keywords：

Stellate ganglion block; sepsis; acute lung injury; ventricular arrhythmia; limb ischemia; neuro-immune modulation

DOI：

10.7507/1002-0179.202503233

Video：

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Abstract Full text Figures/Tables Video References Cited by

Sepsis-associated organ dysfunction arises from uncontrolled inflammation and immune dysregulation, causing microcirculatory impairment and multi-organ failure. Stellate ganglion block (SGB) may confer organ protection by regulating the sympathetic nervous system and hypothalamic-pituitary-adrenal axis to suppress excessive inflammation and oxidative stress. Available evidence, mainly from experimental and small clinical studies, suggests potential benefits of SGB in sepsis-induced acute lung injury, ventricular arrhythmias, and limb ischemia, which require confirmation in multicenter randomized controlled trials. This review outlines the mechanisms and clinical advances of SGB in sepsis-related organ dysfunction, providing a theoretical basis for its application in critical care.

Citation： WANG Linchuan, TANG Xuemei, XIANG Chunlin, WANG Yiping, WU Xiaoxiao. Stellate ganglion block for sepsis-related organ dysfunction: mechanisms and clinical advances. West China Medical Journal, 2025, 40(8): 1333-1339. doi: 10.7507/1002-0179.202503233 Copy

1.	Yuan Y, Chen L. Clinical effect of perioperative stellate ganglion block on mechanical ventilation and respiratory function of elderly patients with septic shock. Medicine (Baltimore), 2024, 103(21): e38166.
2.	劉毅, 趙勁民, 農朋海, 等. 頸胸交感神經的解剖及臨床意義. 中華手外科雜志, 2011, 27(5): 303-305.
3.	Bataille B, Nucci B, Mora M, et al. Ultrasound-guided bilateral stellate ganglion blockade to treat digital ischemia in a patient with sepsis: a case report. Can J Anaesth, 2016, 63(1): 56-60.
4.	Chen Y, Guo L, Lang H, et al. Effect of a stellate ganglion block on acute lung injury in septic rats. Inflammation, 2018, 41(5): 1601-1609.
5.	Benarroch EE. Autonomic nervous system and neuroimmune interactions: new insights and clinical implications. Neurology, 2019, 92(8): 377-385.
6.	Fischer L, Barop H, Ludin SM, et al. Regulation of acute reflectory hyperinflammation in viral and other diseases by means of stellate ganglion block. A conceptual view with a focus on COVID-19. Auton Neurosci, 2022, 237: 102903.
7.	Liu LD, Duricka DL. Stellate ganglion block reduces symptoms of Long COVID: a case series. J Neuroimmunol, 2022, 362: 577784.
8.	Elenkov IJ, Wilder RL, Chrousos GP, et al. The sympathetic nerve--an integrative interface between two supersystems: the brain and the immune system. Pharmacol Rev, 2000, 52(4): 595-638.
9.	Madden KS, Sanders VM, Felten DL. Catecholamine influences and sympathetic neural modulation of immune responsiveness. Annu Rev Pharmacol Toxicol, 1995, 35: 417-448.
10.	Anagnostou VK, Doussis-Anagnostopoulou I, Tiniakos DG, et al. Ontogeny of intrinsic innervation in the human thymus and spleen. J Histochem Cytochem, 2007, 55(8): 813-820.
11.	Yokoyama M, Nakatsuka H, Itano Y, et al. Stellate ganglion block modifies the distribution of lymphocyte subsets and natural-killer cell activity. Anesthesiology, 2000, 92(1): 109-115.
12.	Yang X, Shi Z, Li X, et al. Impacts of stellate ganglion block on plasma NF-κB and inflammatory factors of TBI patients. Int J Clin Exp Med, 2015, 8(9): 15630-15638.
13.	A?a? D, Estrada LD, Maples R, et al. The β₂-adrenergic receptor controls inflammation by driving rapid IL-10 secretion. Brain Behav Immun, 2018, 74: 176-185.
14.	Chavan SS, Pavlov VA, Tracey KJ. Mechanisms and therapeutic relevance of neuro-immune communication. Immunity, 2017, 46(6): 927-942.
15.	Szabadi E. Functional neuroanatomy of the central noradrenergic system. J Psychopharmacol, 2013, 27(8): 659-693.
16.	Hicky A, Hanling S, Pevney E, et al. Stellate ganglion block for PTSD. Am J Psychiatry, 2012, 169(7): 760.
17.	Udit S, Blake K, Chiu IM. Somatosensory and autonomic neuronal regulation of the immune response. Nat Rev Neurosci, 2022, 23(3): 157-171.
18.	Wrona D. Neural-immune interactions: an integrative view of the bidirectional relationship between the brain and immune systems. J Neuroimmunol, 2006, 172(1/2): 38-58.
19.	Lipov E, Gluncic V, Luki? IK, et al. How does stellate ganglion block alleviate immunologically-linked disorders?. Med Hypotheses, 2020, 144: 110000.
20.	Jiang C, Cai L, Zhang J, et al. Stellate ganglion block in the treatment of SAPHO syndrome: a case report. Mod Rheumatol Case Rep, 2024, 8(2): 361-364.
21.	Li Y, Zhang W, Wang H, et al. Case report: a new treatment for restless leg syndrome: three cases. Front Neurosci, 2024, 18: 1333188.
22.	Li Y, Chang J, Shi G, et al. Effects of stellate ganglion block on perimenopausal hot flashes: a randomized controlled trial. Front Endocrinol (Lausanne), 2023, 14: 1293358.
23.	Novy TCT. Effectiveness of ultrasound-guided stellate ganglion block in a patient with Dejerine-Roussy syndrome. Anaesth Pain Intensive Care, 2023, 27(3): 341-343.
24.	Kim YS, Song JH, Kim YJ, et al. Effect of the stellate ganglion block on symptoms of ulcerative colitis: a case report. Medicine (Baltimore), 2021, 100(29): e26684.
25.	Dai S, Ji J, Li R, et al. Stellate ganglion block attenuates LPS-induced acute lung injury by activating Sirt3 regulation of oxidative stress and inflammation. Biomedicines, 2024, 12(6): 1148.
26.	Jeon Y. Therapeutic potential of stellate ganglion block in orofacial pain: a mini review. J Dent Anesth Pain Med, 2016, 16(3): 159-163.
27.	畢燕琳, 王彬, 尹曾, 等. 星狀神經節阻滯對老齡大鼠術后海馬神經元腺苷酸活化蛋白激酶和星形膠質細胞的影響. 中華醫學雜志, 2014, 94(28): 2222-2226.
28.	Zhang J, Liu Y, Li H, et al. Stellate ganglion block improves postoperative cognitive dysfunction in aged rats by SIRT1-mediated white matter lesion repair. Neurochem Res, 2022, 47(12): 3838-3853.
29.	Kumar V. Pulmonary innate immune response determines the outcome of inflammation during pneumonia and sepsis-associated acute lung injury. Front Immunol, 2020, 11: 1722.
30.	Kumar V, Chhibber S. Acute lung inflammation in Klebsiella pneumoniae B5055-induced pneumonia and sepsis in BALB/c mice: a comparative study. Inflammation, 2011, 34(5): 452-462.
31.	Wang L, Yuan N, Li Y, et al. Stellate ganglion block relieves acute lung injury induced by severe acute pancreatitis via the miR-155-5p/SOCS5/JAK2/STAT3 axis. Eur J Med Res, 2022, 27(1): 231.
32.	Shi Y, Li K, Xu K, et al. MiR-155-5p accelerates cerebral ischemia-reperfusion injury via targeting DUSP14 by regulating NF-κB and MAPKs signaling pathways. Eur Rev Med Pharmacol Sci, 2020, 24(3): 1408-1419.
33.	Deng JJ, Zhang CL, Liu DW, et al. Treatment of stellate ganglion block in diseases: its role and application prospect. World J Clin Cases, 2023, 11(10): 2160-2167.
34.	Gu Z, Xin L, Yu H, et al. Cervical sympathetic trunk transection alleviates acute lung injury caused by intestinal obstruction via inhibition of phospholipase A2 in rats. BMC Anesthesiol, 2022, 22(1): 270.
35.	Liu Y, Tao T, Li W, et al. Regulating autonomic nervous system homeostasis improves pulmonary function in rabbits with acute lung injury. BMC Pulm Med, 2017, 17(1): 98.
36.	Zheng X, Lv Z, Yin K, et al. Effects of epidural anesthesia combined with inhalation anesthesia or intravenous anesthesia on intrapulmonary shunt and oxygenation in patients undergoing long term single lung ventilation. Pak J Med Sci, 2018, 34(4): 799-803.
37.	Ganesh A, Qadri YJ, Boortz-Marx RL, et al. Stellate ganglion blockade: an intervention for the management of ventricular arrhythmias. Curr Hypertens Rep, 2020, 22(12): 100.
38.	Shahreyar M, Fahhoum R, Akinseye O, et al. Severe sepsis and cardiac arrhythmias. Ann Transl Med, 2018, 6(1): 6.
39.	Ajijola OA, Hoover DB, Simerly TM, et al. Inflammation, oxidative stress, and glial cell activation characterize stellate ganglia from humans with electrical storm. JCI Insight, 2017, 2(18): e94715.
40.	Meng L, Tseng CH, Shivkumar K, et al. Efficacy of stellate ganglion blockade in managing electrical storm: a systematic review. JACC Clin Electrophysiol, 2017, 3(9): 942-949.
41.	Rajendran PS, Hanna P. The irate stellate ganglion: IL-6 in neuroinflammation-induced ventricular arrhythmias. Heart Rhythm, 2024, 21(5): 620-621.
42.	Zhang D, Tu H, Wang C, et al. Inhibition of N-type calcium channels in cardiac sympathetic neurons attenuates ventricular arrhythmogenesis in heart failure. Cardiovasc Res, 2021, 117(1): 137-148.
43.	Malik V, Shivkumar K. Stellate ganglion blockade for the management of ventricular arrhythmia storm. Eur Heart J, 2024, 45(10): 834-836.
44.	Chouairi F, Rajkumar K, Benak A, et al. A multicenter study of stellate ganglion block as a temporizing treatment for refractory ventricular arrhythmias. JACC Clin Electrophysiol, 2024, 10(4): 750-758.
45.	Morena A, Filippo A, Gravinese C, et al. Clinical profile of patients undergoing percutaneous stellate ganglion block for electrical storm and association with antiarrhythmic efficacy. Eur Heart J, 2024, 45(Suppl 1): ehae666.698.
46.	Chouairi F, Fudim M, Benak A, et al. Factors associated with stellate ganglion block success in recurrent ventricular arrhythmias. ESC Heart Fail, 2025, 12(1): 110-117.
47.	van der Pas VR, van Opstal JM, Scholten MF, et al. Percutaneous left stellate ganglion block for refractory ventricular tachycardia in structural heart disease: our single-centre experience. Neth Heart J, 2024, 32(7/8): 283-289.
48.	Morena A, Gravinese C, Simone F, et al. Percutaneous left stellate ganglion block to increase ventricular fibrillation threshold and defibrillation success rate in acute fulminant myocarditis with electrical storm. Eur Heart J Suppl, 2024, 26(Suppl 2): ii4.
49.	Compagnoni S, Baldi E, Gentile F, et al. Efficacy and safety of percutaneous left stellate ganglion block in patients with refractory electrical storm: our five years experience. Eur Heart J, 2023, 44(Suppl 2): ehad655.651.
50.	Varriale A, Comuzzi A, Biasin M, et al. Electrical storm in COVID-19 infection successfully treated with percutaneous left stellate ganglion blockade. Can J Cardiol, 2023, 39(7): 922-924.
51.	Compagnoni S, Gentile FR, Baldi E, et al. Anatomical-based percutaneous left stellate ganglion block in patients with refractory electrical storm: efficacy and safety. Eur Heart J, 2022, 43(Suppl 2): ehac544.689.
52.	Bourke T, Vaseghi M, Michowitz Y, et al. Neuraxial modulation for refractory ventricular arrhythmias: value of thoracic epidural anesthesia and surgical left cardiac sympathetic denervation. Circulation, 2010, 121(21): 2255-2262.
53.	Buckley U, Yamakawa K, Takamiya T, et al. Targeted stellate decentralization: implications for sympathetic control of ventricular electrophysiology. Heart Rhythm, 2016, 13(1): 282-288.
54.	Feigin G, Velasco Figueroa S, Englesakis MF, et al. Stellate ganglion block for non-pain indications: a scoping review. Pain Med, 2023, 24(7): 775-781.
55.	Zhang D, Hu W, Tu H, et al. Macrophage depletion in stellate ganglia alleviates cardiac sympathetic overactivation and ventricular arrhythmogenesis by attenuating neuroinflammation in heart failure. Basic Res Cardiol, 2021, 116(1): 28.
56.	Xiong S, Sun HJ, Cao L, et al. Stimulation of Na⁺/K⁺-ATPase with an antibody against its 4th extracellular region attenuates angiotensin II-induced H9c2 cardiomyocyte hypertrophy via an AMPK/SIRT3/PPAR γ signaling pathway. Oxid Med Cell Longev, 2019, 2019: 4616034.
57.	Oh TK, Song IA. Incidence and associated risk factors for limb amputation among sepsis survivors in South Korea. J Anesth, 2021, 35(1): 51-58.
58.	Reitz KM, Kennedy J, Rieser C, et al. The epidemiology of extremity threat and amputation after vasopressor-dependent sepsis. Ann Am Thorac Soc, 2022, 19(4): 625-632.
59.	Tran DQ, Finlayson RJ. Use of stellate ganglion block to salvage an ischemic hand caused by the extravasation of vasopressors. Reg Anesth Pain Med, 2005, 30(4): 405-408.
60.	Kim MK, Yi MS, Park PG, et al. Effect of stellate ganglion block on the regional hemodynamics of the upper extremity: a randomized controlled trial. Anesth Analg, 2018, 126(5): 1705-1711.
61.	薛翔, 劉紅梅, 邵旦兵, 等. 腦出血并發應激性潰瘍危險因素的 logistic 回歸分析. 中華危重病急救醫學, 2014, 26(10): 730-733.
62.	吳貴龍, 薛張剛, 朋立超, 等. 星狀神經節阻滯對顱腦外傷急診手術患者術中胃黏膜 pHi 的影響. 中國臨床醫學, 2010, 17(2): 248-250.
63.	Zhao HY, Yang GT, Sun NN, et al. Efficacy and safety of stellate ganglion block in chronic ulcerative colitis. World J Gastroenterol, 2017, 23(3): 533-539.
64.	Wen B, Wang Y, Zhang C, et al. Effect of stellate ganglion block on postoperative recovery of gastrointestinal function in patients undergoing surgery with general anaesthesia: a meta-analysis. BMC Surg, 2020, 20(1): 284.
65.	Daisuke H, Tetsuro M, Risabur? S. 1177: Prevalence and prognosis of sepsis-induced cardiomyopathy: a systematic review and meta-analysis. Crit Care Med, 2023, 51(1): 587.
66.	Tsolaki V, Makris D, Mantzarlis K, et al. Sepsis-induced cardiomyopathy: oxidative implications in the initiation and resolution of the damage. Oxid Med Cell Longev, 2017, 2017: 7393525.
67.	Kawaguchi S, Okada M. Cardiac metabolism in sepsis. Metabolites, 2021, 11(12): 846.
68.	Wu R, Yu T, Chen X, et al. Sigma-1R overexpression in PVN deteriorated heart injury by upregulating sympathetic nerve tone. Res Square, 2022: rs.3.rs-1884589.
69.	宋嘉昱, 赫一鳴, 周凱旋, 等. 鐵死亡在膿毒性心肌病中的作用機制研究進展. 中華危重病急救醫學, 2022, 34(10): 1107-1111.
70.	Liu S, Zhang C, Shi Q, et al. Puerarin blocks the signaling transmission mediated by P2X3 in SG and DRG to relieve myocardial ischemic damage. Brain Res Bull, 2014, 101: 57-63.
71.	Arai T, Kanazawa H, Kimura K, et al. Upregulation of neuropeptide Y in cardiac sympathetic nerves induces stress (Takotsubo) cardiomyopathy. Front Neurosci, 2022, 16: 1013712.
72.	Bugga P, Alam MJ, Kumar R, et al. Sirt3 ameliorates mitochondrial dysfunction and oxidative stress through regulating mitochondrial biogenesis and dynamics in cardiomyoblast. Cell Signal, 2022, 94: 110309.
73.	陳永權, 胡光祥, 付群, 等. 星狀神經節阻滯對自發性高血壓大鼠心肌細胞凋亡與 Bcl-2, Bax 蛋白表達的影響. 中南大學學報(醫學版), 2013, 38(9): 896-901.
74.	Yu Z, Liu Z, Jiao L, et al. Bmal1 knockdown in the left stellate ganglion inhibits neural activity and prevents ventricular arrhythmias after myocardial ischemia. Front Cardiovasc Med, 2022, 9: 937608.
75.	Hong Y, Chen P, Gao J, et al. Sepsis-associated encephalopathy: from pathophysiology to clinical management. Int Immunopharmacol, 2023, 124(Pt A): 110800.
76.	Yu K, Zhang XK, Xiong HC, et al. Stellate ganglion block alleviates postoperative cognitive dysfunction via inhibiting TLR4/NF-κB signaling pathway. Neurosci Lett, 2023, 807: 137259.
77.	陳永權, 付群, 金孝岠. 星狀神經節阻滯對自發性高血壓大鼠腦組織 NF-κBp65 與凋亡調節因子 bcl-2/bax 表達變化的影響. 臨床醫學, 2015(6): 107-109.
78.	Li Y, Loshak H. Stellate ganglion block for the treatment of post-traumatic stress disorder, depression, and anxiety [Internet]. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health, 2021, 1(3): 2563-2596.
79.	Li TT, Wan Q, Zhang X, et al. Stellate ganglion block reduces inflammation and improves neurological function in diabetic rats during ischemic stroke. Neural Regen Res, 2022, 17(9): 1991-1997.
80.	杜曉紅, 徐國海, 胡衍輝. 星狀神經節阻滯對心肺轉流腦損傷的影響. 臨床麻醉學雜志, 2010, 26(5): 394-396.
81.	Deng X, Sun T, Zhao D, et al. Stellate ganglion block potentially ameliorates postoperative cognitive decline in aged rats by regulating the neuroendocrine response to stress. Heliyon, 2023, 9(3): e14337.
82.	Kim SJ. Stellate ganglion block for refractory post-COVID headache: case report. Pain Med Case Rep, 2023, 7(2): 73-76.
83.	Goel V, Patwardhan AM, Ibrahim M, et al. Complications associated with stellate ganglion nerve block: a systematic review. Reg Anesth Pain Med, 2019, 44(6): 669-678.
84.	Hirota K, Hirata K, Shibata S, et al. Risk vessels of retropharyngeal hematoma during stellate ganglion block. Reg Anesth Pain Med, 2017, 42(6): 778-781.
85.	Chaturvedi A, Dash H. Locked-in syndrome during stellate ganglion block. Indian J Anaesth, 2010, 54(4): 324-326.

1. Yuan Y, Chen L. Clinical effect of perioperative stellate ganglion block on mechanical ventilation and respiratory function of elderly patients with septic shock. Medicine (Baltimore), 2024, 103(21): e38166.
2. 劉毅, 趙勁民, 農朋海, 等. 頸胸交感神經的解剖及臨床意義. 中華手外科雜志, 2011, 27(5): 303-305.
3. Bataille B, Nucci B, Mora M, et al. Ultrasound-guided bilateral stellate ganglion blockade to treat digital ischemia in a patient with sepsis: a case report. Can J Anaesth, 2016, 63(1): 56-60.
4. Chen Y, Guo L, Lang H, et al. Effect of a stellate ganglion block on acute lung injury in septic rats. Inflammation, 2018, 41(5): 1601-1609.
5. Benarroch EE. Autonomic nervous system and neuroimmune interactions: new insights and clinical implications. Neurology, 2019, 92(8): 377-385.
6. Fischer L, Barop H, Ludin SM, et al. Regulation of acute reflectory hyperinflammation in viral and other diseases by means of stellate ganglion block. A conceptual view with a focus on COVID-19. Auton Neurosci, 2022, 237: 102903.
7. Liu LD, Duricka DL. Stellate ganglion block reduces symptoms of Long COVID: a case series. J Neuroimmunol, 2022, 362: 577784.
8. Elenkov IJ, Wilder RL, Chrousos GP, et al. The sympathetic nerve--an integrative interface between two supersystems: the brain and the immune system. Pharmacol Rev, 2000, 52(4): 595-638.
9. Madden KS, Sanders VM, Felten DL. Catecholamine influences and sympathetic neural modulation of immune responsiveness. Annu Rev Pharmacol Toxicol, 1995, 35: 417-448.
10. Anagnostou VK, Doussis-Anagnostopoulou I, Tiniakos DG, et al. Ontogeny of intrinsic innervation in the human thymus and spleen. J Histochem Cytochem, 2007, 55(8): 813-820.
11. Yokoyama M, Nakatsuka H, Itano Y, et al. Stellate ganglion block modifies the distribution of lymphocyte subsets and natural-killer cell activity. Anesthesiology, 2000, 92(1): 109-115.
12. Yang X, Shi Z, Li X, et al. Impacts of stellate ganglion block on plasma NF-κB and inflammatory factors of TBI patients. Int J Clin Exp Med, 2015, 8(9): 15630-15638.
13. A?a? D, Estrada LD, Maples R, et al. The β₂-adrenergic receptor controls inflammation by driving rapid IL-10 secretion. Brain Behav Immun, 2018, 74: 176-185.
14. Chavan SS, Pavlov VA, Tracey KJ. Mechanisms and therapeutic relevance of neuro-immune communication. Immunity, 2017, 46(6): 927-942.
15. Szabadi E. Functional neuroanatomy of the central noradrenergic system. J Psychopharmacol, 2013, 27(8): 659-693.
16. Hicky A, Hanling S, Pevney E, et al. Stellate ganglion block for PTSD. Am J Psychiatry, 2012, 169(7): 760.
17. Udit S, Blake K, Chiu IM. Somatosensory and autonomic neuronal regulation of the immune response. Nat Rev Neurosci, 2022, 23(3): 157-171.
18. Wrona D. Neural-immune interactions: an integrative view of the bidirectional relationship between the brain and immune systems. J Neuroimmunol, 2006, 172(1/2): 38-58.
19. Lipov E, Gluncic V, Luki? IK, et al. How does stellate ganglion block alleviate immunologically-linked disorders?. Med Hypotheses, 2020, 144: 110000.
20. Jiang C, Cai L, Zhang J, et al. Stellate ganglion block in the treatment of SAPHO syndrome: a case report. Mod Rheumatol Case Rep, 2024, 8(2): 361-364.
21. Li Y, Zhang W, Wang H, et al. Case report: a new treatment for restless leg syndrome: three cases. Front Neurosci, 2024, 18: 1333188.
22. Li Y, Chang J, Shi G, et al. Effects of stellate ganglion block on perimenopausal hot flashes: a randomized controlled trial. Front Endocrinol (Lausanne), 2023, 14: 1293358.
23. Novy TCT. Effectiveness of ultrasound-guided stellate ganglion block in a patient with Dejerine-Roussy syndrome. Anaesth Pain Intensive Care, 2023, 27(3): 341-343.
24. Kim YS, Song JH, Kim YJ, et al. Effect of the stellate ganglion block on symptoms of ulcerative colitis: a case report. Medicine (Baltimore), 2021, 100(29): e26684.
25. Dai S, Ji J, Li R, et al. Stellate ganglion block attenuates LPS-induced acute lung injury by activating Sirt3 regulation of oxidative stress and inflammation. Biomedicines, 2024, 12(6): 1148.
26. Jeon Y. Therapeutic potential of stellate ganglion block in orofacial pain: a mini review. J Dent Anesth Pain Med, 2016, 16(3): 159-163.
27. 畢燕琳, 王彬, 尹曾, 等. 星狀神經節阻滯對老齡大鼠術后海馬神經元腺苷酸活化蛋白激酶和星形膠質細胞的影響. 中華醫學雜志, 2014, 94(28): 2222-2226.
28. Zhang J, Liu Y, Li H, et al. Stellate ganglion block improves postoperative cognitive dysfunction in aged rats by SIRT1-mediated white matter lesion repair. Neurochem Res, 2022, 47(12): 3838-3853.
29. Kumar V. Pulmonary innate immune response determines the outcome of inflammation during pneumonia and sepsis-associated acute lung injury. Front Immunol, 2020, 11: 1722.
30. Kumar V, Chhibber S. Acute lung inflammation in Klebsiella pneumoniae B5055-induced pneumonia and sepsis in BALB/c mice: a comparative study. Inflammation, 2011, 34(5): 452-462.
31. Wang L, Yuan N, Li Y, et al. Stellate ganglion block relieves acute lung injury induced by severe acute pancreatitis via the miR-155-5p/SOCS5/JAK2/STAT3 axis. Eur J Med Res, 2022, 27(1): 231.
32. Shi Y, Li K, Xu K, et al. MiR-155-5p accelerates cerebral ischemia-reperfusion injury via targeting DUSP14 by regulating NF-κB and MAPKs signaling pathways. Eur Rev Med Pharmacol Sci, 2020, 24(3): 1408-1419.
33. Deng JJ, Zhang CL, Liu DW, et al. Treatment of stellate ganglion block in diseases: its role and application prospect. World J Clin Cases, 2023, 11(10): 2160-2167.
34. Gu Z, Xin L, Yu H, et al. Cervical sympathetic trunk transection alleviates acute lung injury caused by intestinal obstruction via inhibition of phospholipase A2 in rats. BMC Anesthesiol, 2022, 22(1): 270.
35. Liu Y, Tao T, Li W, et al. Regulating autonomic nervous system homeostasis improves pulmonary function in rabbits with acute lung injury. BMC Pulm Med, 2017, 17(1): 98.
36. Zheng X, Lv Z, Yin K, et al. Effects of epidural anesthesia combined with inhalation anesthesia or intravenous anesthesia on intrapulmonary shunt and oxygenation in patients undergoing long term single lung ventilation. Pak J Med Sci, 2018, 34(4): 799-803.
37. Ganesh A, Qadri YJ, Boortz-Marx RL, et al. Stellate ganglion blockade: an intervention for the management of ventricular arrhythmias. Curr Hypertens Rep, 2020, 22(12): 100.
38. Shahreyar M, Fahhoum R, Akinseye O, et al. Severe sepsis and cardiac arrhythmias. Ann Transl Med, 2018, 6(1): 6.
39. Ajijola OA, Hoover DB, Simerly TM, et al. Inflammation, oxidative stress, and glial cell activation characterize stellate ganglia from humans with electrical storm. JCI Insight, 2017, 2(18): e94715.
40. Meng L, Tseng CH, Shivkumar K, et al. Efficacy of stellate ganglion blockade in managing electrical storm: a systematic review. JACC Clin Electrophysiol, 2017, 3(9): 942-949.
41. Rajendran PS, Hanna P. The irate stellate ganglion: IL-6 in neuroinflammation-induced ventricular arrhythmias. Heart Rhythm, 2024, 21(5): 620-621.
42. Zhang D, Tu H, Wang C, et al. Inhibition of N-type calcium channels in cardiac sympathetic neurons attenuates ventricular arrhythmogenesis in heart failure. Cardiovasc Res, 2021, 117(1): 137-148.
43. Malik V, Shivkumar K. Stellate ganglion blockade for the management of ventricular arrhythmia storm. Eur Heart J, 2024, 45(10): 834-836.
44. Chouairi F, Rajkumar K, Benak A, et al. A multicenter study of stellate ganglion block as a temporizing treatment for refractory ventricular arrhythmias. JACC Clin Electrophysiol, 2024, 10(4): 750-758.
45. Morena A, Filippo A, Gravinese C, et al. Clinical profile of patients undergoing percutaneous stellate ganglion block for electrical storm and association with antiarrhythmic efficacy. Eur Heart J, 2024, 45(Suppl 1): ehae666.698.
46. Chouairi F, Fudim M, Benak A, et al. Factors associated with stellate ganglion block success in recurrent ventricular arrhythmias. ESC Heart Fail, 2025, 12(1): 110-117.
47. van der Pas VR, van Opstal JM, Scholten MF, et al. Percutaneous left stellate ganglion block for refractory ventricular tachycardia in structural heart disease: our single-centre experience. Neth Heart J, 2024, 32(7/8): 283-289.
48. Morena A, Gravinese C, Simone F, et al. Percutaneous left stellate ganglion block to increase ventricular fibrillation threshold and defibrillation success rate in acute fulminant myocarditis with electrical storm. Eur Heart J Suppl, 2024, 26(Suppl 2): ii4.
49. Compagnoni S, Baldi E, Gentile F, et al. Efficacy and safety of percutaneous left stellate ganglion block in patients with refractory electrical storm: our five years experience. Eur Heart J, 2023, 44(Suppl 2): ehad655.651.
50. Varriale A, Comuzzi A, Biasin M, et al. Electrical storm in COVID-19 infection successfully treated with percutaneous left stellate ganglion blockade. Can J Cardiol, 2023, 39(7): 922-924.
51. Compagnoni S, Gentile FR, Baldi E, et al. Anatomical-based percutaneous left stellate ganglion block in patients with refractory electrical storm: efficacy and safety. Eur Heart J, 2022, 43(Suppl 2): ehac544.689.
52. Bourke T, Vaseghi M, Michowitz Y, et al. Neuraxial modulation for refractory ventricular arrhythmias: value of thoracic epidural anesthesia and surgical left cardiac sympathetic denervation. Circulation, 2010, 121(21): 2255-2262.
53. Buckley U, Yamakawa K, Takamiya T, et al. Targeted stellate decentralization: implications for sympathetic control of ventricular electrophysiology. Heart Rhythm, 2016, 13(1): 282-288.
54. Feigin G, Velasco Figueroa S, Englesakis MF, et al. Stellate ganglion block for non-pain indications: a scoping review. Pain Med, 2023, 24(7): 775-781.
55. Zhang D, Hu W, Tu H, et al. Macrophage depletion in stellate ganglia alleviates cardiac sympathetic overactivation and ventricular arrhythmogenesis by attenuating neuroinflammation in heart failure. Basic Res Cardiol, 2021, 116(1): 28.
56. Xiong S, Sun HJ, Cao L, et al. Stimulation of Na⁺/K⁺-ATPase with an antibody against its 4th extracellular region attenuates angiotensin II-induced H9c2 cardiomyocyte hypertrophy via an AMPK/SIRT3/PPAR γ signaling pathway. Oxid Med Cell Longev, 2019, 2019: 4616034.
57. Oh TK, Song IA. Incidence and associated risk factors for limb amputation among sepsis survivors in South Korea. J Anesth, 2021, 35(1): 51-58.
58. Reitz KM, Kennedy J, Rieser C, et al. The epidemiology of extremity threat and amputation after vasopressor-dependent sepsis. Ann Am Thorac Soc, 2022, 19(4): 625-632.
59. Tran DQ, Finlayson RJ. Use of stellate ganglion block to salvage an ischemic hand caused by the extravasation of vasopressors. Reg Anesth Pain Med, 2005, 30(4): 405-408.
60. Kim MK, Yi MS, Park PG, et al. Effect of stellate ganglion block on the regional hemodynamics of the upper extremity: a randomized controlled trial. Anesth Analg, 2018, 126(5): 1705-1711.
61. 薛翔, 劉紅梅, 邵旦兵, 等. 腦出血并發應激性潰瘍危險因素的 logistic 回歸分析. 中華危重病急救醫學, 2014, 26(10): 730-733.
62. 吳貴龍, 薛張剛, 朋立超, 等. 星狀神經節阻滯對顱腦外傷急診手術患者術中胃黏膜 pHi 的影響. 中國臨床醫學, 2010, 17(2): 248-250.
63. Zhao HY, Yang GT, Sun NN, et al. Efficacy and safety of stellate ganglion block in chronic ulcerative colitis. World J Gastroenterol, 2017, 23(3): 533-539.
64. Wen B, Wang Y, Zhang C, et al. Effect of stellate ganglion block on postoperative recovery of gastrointestinal function in patients undergoing surgery with general anaesthesia: a meta-analysis. BMC Surg, 2020, 20(1): 284.
65. Daisuke H, Tetsuro M, Risabur? S. 1177: Prevalence and prognosis of sepsis-induced cardiomyopathy: a systematic review and meta-analysis. Crit Care Med, 2023, 51(1): 587.
66. Tsolaki V, Makris D, Mantzarlis K, et al. Sepsis-induced cardiomyopathy: oxidative implications in the initiation and resolution of the damage. Oxid Med Cell Longev, 2017, 2017: 7393525.
67. Kawaguchi S, Okada M. Cardiac metabolism in sepsis. Metabolites, 2021, 11(12): 846.
68. Wu R, Yu T, Chen X, et al. Sigma-1R overexpression in PVN deteriorated heart injury by upregulating sympathetic nerve tone. Res Square, 2022: rs.3.rs-1884589.
69. 宋嘉昱, 赫一鳴, 周凱旋, 等. 鐵死亡在膿毒性心肌病中的作用機制研究進展. 中華危重病急救醫學, 2022, 34(10): 1107-1111.
70. Liu S, Zhang C, Shi Q, et al. Puerarin blocks the signaling transmission mediated by P2X3 in SG and DRG to relieve myocardial ischemic damage. Brain Res Bull, 2014, 101: 57-63.
71. Arai T, Kanazawa H, Kimura K, et al. Upregulation of neuropeptide Y in cardiac sympathetic nerves induces stress (Takotsubo) cardiomyopathy. Front Neurosci, 2022, 16: 1013712.
72. Bugga P, Alam MJ, Kumar R, et al. Sirt3 ameliorates mitochondrial dysfunction and oxidative stress through regulating mitochondrial biogenesis and dynamics in cardiomyoblast. Cell Signal, 2022, 94: 110309.
73. 陳永權, 胡光祥, 付群, 等. 星狀神經節阻滯對自發性高血壓大鼠心肌細胞凋亡與 Bcl-2, Bax 蛋白表達的影響. 中南大學學報(醫學版), 2013, 38(9): 896-901.
74. Yu Z, Liu Z, Jiao L, et al. Bmal1 knockdown in the left stellate ganglion inhibits neural activity and prevents ventricular arrhythmias after myocardial ischemia. Front Cardiovasc Med, 2022, 9: 937608.
75. Hong Y, Chen P, Gao J, et al. Sepsis-associated encephalopathy: from pathophysiology to clinical management. Int Immunopharmacol, 2023, 124(Pt A): 110800.
76. Yu K, Zhang XK, Xiong HC, et al. Stellate ganglion block alleviates postoperative cognitive dysfunction via inhibiting TLR4/NF-κB signaling pathway. Neurosci Lett, 2023, 807: 137259.
77. 陳永權, 付群, 金孝岠. 星狀神經節阻滯對自發性高血壓大鼠腦組織 NF-κBp65 與凋亡調節因子 bcl-2/bax 表達變化的影響. 臨床醫學, 2015(6): 107-109.
78. Li Y, Loshak H. Stellate ganglion block for the treatment of post-traumatic stress disorder, depression, and anxiety [Internet]. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health, 2021, 1(3): 2563-2596.
79. Li TT, Wan Q, Zhang X, et al. Stellate ganglion block reduces inflammation and improves neurological function in diabetic rats during ischemic stroke. Neural Regen Res, 2022, 17(9): 1991-1997.
80. 杜曉紅, 徐國海, 胡衍輝. 星狀神經節阻滯對心肺轉流腦損傷的影響. 臨床麻醉學雜志, 2010, 26(5): 394-396.
81. Deng X, Sun T, Zhao D, et al. Stellate ganglion block potentially ameliorates postoperative cognitive decline in aged rats by regulating the neuroendocrine response to stress. Heliyon, 2023, 9(3): e14337.
82. Kim SJ. Stellate ganglion block for refractory post-COVID headache: case report. Pain Med Case Rep, 2023, 7(2): 73-76.
83. Goel V, Patwardhan AM, Ibrahim M, et al. Complications associated with stellate ganglion nerve block: a systematic review. Reg Anesth Pain Med, 2019, 44(6): 669-678.
84. Hirota K, Hirata K, Shibata S, et al. Risk vessels of retropharyngeal hematoma during stellate ganglion block. Reg Anesth Pain Med, 2017, 42(6): 778-781.
85. Chaturvedi A, Dash H. Locked-in syndrome during stellate ganglion block. Indian J Anaesth, 2010, 54(4): 324-326.

West China Medical Journal

Stellate ganglion block for sepsis-related organ dysfunction: mechanisms and clinical advances

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