Ischemic Heart Disease
Conditions
Brief summary
The effects of SGB on the cardiovascular system remain controversial since the cardiac sympathetic nerves pass through the stellate ganglion. SGB is expected to have an ameliorative effect on impaired coronary circulation and cardiac function and thus to be well suited to the treatment of angina pectoris and myocardial infarction
Detailed description
investigators chose left SGB being safer with regards conductivity changes when compared to right SGB, in the present study investigators are trying to examine and compare whether coronary reperfusion in patients undergoing coronary artery bypass grafting who were subject to ultrasound guided left Stellate ganglion block (SGB ) performed in the induction of anesthesia could decrease post cardiopulmonary bypass ischemic changes, pulmonary hypertension and right ventricular dysfunction leading to enhanced recovery. Place of work: Ain shams university hospitals cardiovascular surgery academy, Cairo, Egypt. Number and selection of participants: 40 participants, 20 in each group (2 groups).
Interventions
OTHERultrasound guided left stellate ganglion block
Stellate Ganglion Block (SGB) has several established clinical indications Under complete aseptic precautions an ultrasound guided left stellate ganglion block was performed. (paratracheal technique ) ( ) The patient was placed in the supine position with the head in the neutral position and slightly extended. An initial scanning was done with the ultrasound to identify the structures in this area. The US probe was placed at the level of the cricoid cartilage. The transverse process of the sixth cervical vertebra was identified by its prominent anterior tubercle. Also, the longus colli muscle and its overlying prevertebral fascia were sought anterior to the C6 vertebral body and deep to the carotid artery. After skin infiltration with local anesthetic, the needle was inserted from lateral to medial using the in-plane technique. The aim was to inject the local anesthetics deep to the prevertebral fascia and above the longus colli
Sponsors
Ain Shams University
wail abdelaal
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
DOUBLE (Subject, Investigator)
Intervention model description
US machine Mindray M5 (Shenzhen Mindray Bio-Medical Electronics Co., LTD. Shenzhen, China.) with a linear 38-mm high frequency 10-12 MHz transducer), with an imaging depth of 4 cm. A 50-mm short bevel 22-gauge insulated stimulating needle (PAJUNK® GmbH Medizin technologie, Deutschland) was used
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Ischemic heart disease patients age above 18 years
Exclusion criteria
allergy to LA, severe COPD
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| change in heart rate | change in heart rate from base line | heart rate( bpm ) |
| change in Ejection Fraction | change in Ejection Fraction from base line | Ejection Fraction(%) |
| change in blood pressure | change in blood pressure from base line | MAP, Systemic arterial pressure ( mmHg ) |
| change in cardiac rhythm | change in cardiac rhythm from base line | incidence of AF or VF(BPM) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| effect of preoperative stellate ganglion block on enhanced recovery after coronary arteries bypass grafting surgery | change of troponin level from base line | measuring troponin level (ng/ml) |
Countries
Egypt
Outcome results
None listed