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PubMed1982

Potentiation of the ganglionic blocking action of norepinephrine by cocaine.

Concentration-response curves for the blocking action of norepinephrine were determined in the isolated stellate ganglion of the hamster. The blocking effect of norepinephrine on the postganglionic compound action potential from preganglionic nerve stimulation at 0.2 Hz was reduced by phentolamine (10(-5) M), but was not altered by propranolol (10(-6) M). Cocaine (10(-6) and 10(-5) M) increased the sensitivity of the ganglion to norepinephrine. These concentrations of cocaine produced less than 25% blockade when applied alone. The local anesthetic, procaine, did not change the sensitivity of the ganglion to norepinephrine. The blockade by norepinephrine in the presence of cocaine was antagonized by phentolamine and unaffected by propranolol. The time course of the blockade by norepinephrine was more rapid in onset and slower in recovery in the presence of cocaine. If it is assumed that cocaine is blocking norepinephrine uptake into cells within the ganglion, these results indicate that the catecholamine uptake mechanism is involved in terminating the blocking action of exogenously applied norepinephrine.

Animals↗
PubMedDate not supplied

Dysrhythmias controlled with stellate ganglion block in a child with diabetes and a variant of long QT syndrome.

BACKGROUND AND OBJECTIVES: A 9-year-old boy with a history of poorly controlled insulin-dependent diabetes mellitus was found at home unresponsive. QT prolongation was diagnosed on inspection of Holter monitoring performed immediately before episodes of ventricular fibrillation. METHODS: In spite of medical management with propranolol, esmolol, phenytoin, and diazepam, the patient continued to have episodes of QT prolongation followed by ventricular dysrhythmias that reverted to sinus rhythm only after cardiopulmonary resuscitation and cardioversion. RESULTS: A series of left stellate ganglion blocks with bupivacaine eradicated the dysrhythmias. The child was then referred to another institution for insertion of an automatic internal cardioverter defibrillator. CONCLUSIONS: This case report emphasizes the effectiveness of left stellate ganglion block with bupivacaine in a child with a variant of long QT syndrome.

Autonomic Nerve Block↗
PubMed1969

Role of catecholamines in centrogenic cardiac arrhythmia induced by aconitine.

1. Injection of 20 mug of aconitine into the lateral ventricle of dogs anaesthetized with pentobarbitone regularly induced cardiac irregularities and hypertension. The cardiovascular changes appeared within 5 min and lasted for about 90 min. Tachyphylaxis to the aconitine-induced cardiovascular effects was observed.2. The aconitine-induced arrhythmia and hypertension were centrogenic, for they were abolished or prevented by spinal transection (C(2)) or ganglionic blockade.3. Bilateral vagotomy as well as bilateral stellate ganglionectomy merely raised the threshold for arrhythmia without affecting the blood pressure response. The neural supply to the heart, therefore, does not seem to be the major pathway concerned in the genesis of the centrogenic cardiovascular effects of aconitine.4. The centrally evoked release of endogenous catecholamines from the adrenal glands was responsible for the aconitine-induced arrhythmia, since the arrhythmia could be blocked or prevented by prior reserpinization, bilateral adrenalectomy or thoracic splanchnic nerve section.5. alpha- and beta-adrenoceptive receptor blocking agents prevented or abolished the aconitine-induced arrhythmia in a manner similar to the catecholamine-induced arrhythmia.

Aconitum↗