Comparison of Lidocaine and Mepivacaine for Variation on Regional Tissue Oxygenation in Stellate Ganglion Block: A Randomized, Double-blind, Crossover Trial

Abstract

Abstract This prospective, randomized, double-blind, crossover trial aimed to investigate the effect of different types of local anesthetics on regional tissue blood oxygenation on the stellate ganglion block (SGB). Twenty eligible patients were recruited for this study, 16 of which were allocated to the study protocol. Participants were randomized into one of the two crossover sequences to 1% lidocaine hydrochloride or 1% mepivacaine hydrochloride and received SGBs with 6 mL of either local anesthetic, followed by a washout period of more than 24 h, and received SGBs by substituting the two local anesthetics. The tissue oxygenation index (TOI) in the skin near the mental foramen on the blocked side was recorded using near-infrared spectroscopy at 15 min after the local anesthetic injection. One participant did not complete the study. As such, variation in regional tissue oxygenation was compared between the 15 participants. There was no difference in the increase in regional tissue blood flow or tissue oxygenation after SGB between lidocaine and mepivacaine; however, the kinetics of the increase in regional tissue oxygenation were significantly faster with mepivacaine than with lidocaine. This study was registered in the UMIN Clinical Trials Registry (UMIN000040404) and the authors declare that they have no funding.