Stellate Ganglion Block
Conditions
Brief summary
Post-operative new-onset atrial fibrillation (POAF) is one of the most common arrhythmias in adults after direct intracardiac surgery with extracorporeal circulation. The incidence of POAF in coronary artery bypass grafting (CABG) is approximately 30%. POAF can lead to an increased risk of complications such as stroke, heart failure, and acute kidney injury, which not only prolongs the patient's hospital stay, but also increases hospital costs and mortality. operation, extracorporeal circulation, and the patient's underlying conditions (such as age, gender, hypertension, and diabetes), which cause sympathetic activation, inflammatory response, and myocardial ischemia in the organism. The stellate ganglion block (SGB) regulates the sympathetic tone of the innervated nerves and thus the autonomic function of the body. SGB can effectively regulate the sympathetic-parasympathetic imbalance. Also, SGB may exert some anti-inflammatory effects. In this study, ultrasound-guided SGB was used in CABG patients to investigate its effect on the occurrence of POAF.
Interventions
PROCEDUREStellate nerve block
Before the operation, the left stellate ganglion block was performed, and 0.375% ropivacaine 5ml was injected into the stellate ganglion.
Sponsors
Yangzhou University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* Patients undergoing first-time and elective coronary artery bypass grafting; * ASA grade II-IV； * The preoperative ECG showed sinus heart rate.
Exclusion criteria
* The patient refused to participate in this study; * Surgical procedures include any other type of heart surgery in addition to CABG； * Allergic to known general anesthesia drugs; * Patients with a history of neck surgery or abnormal neck anatomy; * Patients with contraindications to SGB.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The occurrence of new atrial fibrillation was detected by ECG monitoring | Within 5 days after surgery | ECG monitor shows atrial fibrillation. To be specific: 1)Irregular R-R interval (when atrioventricular conduction is present), 2) P wave disappearance, 3) irregular atrial activity. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Duration of the first episode of POAF | within 5 days after surgery | The duration from the onset to the resolution of the first atrial fibrillation after surgery. |
| Need for Antiarrhythmic treatments | within 5 days after the operation | Record the types of medications used and whether electrical cardioversion has been used. |
| the concentration of interleukin-6 | end of surgery, 24 hour postoperatively, 72hour postoperatively, 5 day postoperatively | Interleukin-6 (IL-6) is an important cytokine that plays a key role in immune responses, inflammation, and tumor development. |
| the concentration of CRP | end of surgery,24 hour postoperatively ,72 hour postoperatively ,5 day postoperatively | C-reactive protein (CRP) is a protein produced by the liver that is mainly used to indicate the presence of inflammation in the body. |
| AF burden | within 5 days after surgery | The percentage of the time during which atrial fibrillation occurs in the overall recorded time. |
| the concentration of Hs-cTnT | end of surgery, 24hour postoperatively, 72hour postoperatively | hs-cTnT is an important biomarker used for detecting cardiac injury. |
| the concentration of CK-MB | end of surgery, 24hour postoperatively, 72hour postoperatively | CK-MB is an enzyme primarily found in cardiac muscle cells. Its concentration is commonly used to assess cardiac damage, especially in the case of myocardial infarction |
| postoperative adverse reactions | From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 100 months | Record the occurrence of adverse reactions postoperative |
| Changes of intraoperative Left ventricular diastolic function | T1 (after sternotomy and before CPB) and T2 (30 minute after CPB cessation). | Left ventricular diastolic function were measured by transesophageal echocardiography (TEE) |
Countries
China
Outcome results
None listed