Stellate ganglion block potentially ameliorates postoperative cognitive decline in aged rats by regulating the neuroendocrine response to stress

Abstract

Background: Postoperative cognitive dysfunction (POCD) is a common postoperative complication in elderly patients. The strong stress response causing by surgical trauma can induce POCD. We hypothesized that stellate ganglion block (SGB) can provide the neuroprotection to POCD by regulating the neuroendocrine response. Methods: Sprague-Dawley male rats, 18–20 months old and weighing 550–650 g were assigned into four groups: sham surgery group (Sham), sham surgery + saline group (Sham + NS), surgery group (Surgery), and surgery + SGB group (Surgery + SGB). The change of body weight, heart rate variability analysis, behavior testing, neuronal damage, inflammatory response, neuroendocrine hormone level were evaluated by their corresponding methods. Results: The results showed that SGB can reduce the number of both types of errors in the postoperative eight-arm maze assay, attenuate neural structural damage, inhibit neuroapoptosis, suppress inflammatory responses, increase the release of neurotrophic factors, accelerate postoperative weight recovery, and promote postoperative recovery in rats. Most importantly, SGB reduced the level of neuroendocrine hormone of TH, Cyp11b1, CRH, and SGB also activated dorsal motor nucleus of vagus (detected by c-fos immunohistochemistry). Conclusions: Our findings indicated that SGB could be a neuroprotective therapy for the cognitive dysfunction induced by exploratory laparotomy model of POCD, which might be attributable for balancing the autonomic nervous system, regulating hypothalamic-pituitary-adrenal (HPA) axis system.

Keywords

• Postoperative cognitive dysfunction
• Stellate ganglion block
• Neuroendocrine stress response
• Autonomic nervous system
• HPA axis