Preoperative left stellate ganglion block: Does it offer arrhythmia-protection during off-pump CABG surgery? A randomized clinical trial

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Abstract

Background
Cardiac arrhythmias are not uncommon during and after coronary artery bypass graft cardiac surgeries. Preliminary studies showed the preventive effects of stellate ganglion block upon cardiac arrhythmias; however, this could be the 1 study focusing upon intraoperative arrhythmias during offpump coronary artery bypass graft surgery as a main goal.
Methods
This is a randomized controlled trial. The study involved forty adult patients undergoing elective offpump coronary artery bypass graft surgery. Twenty patients received left SGB with 10 ml of 2% lidocaine before induction of anesthesia (B group), and twenty patients as a control group (A group). Intraoperative and 24-hours postoperative electrocardiogram and hemodynamics were monitored, in addition to the mean postoperative 24-hours inotropic score.
Results
There was a significantly higher incidence of intraoperative arrhythmias in the control group in the form of bradyarrhythmia (25%), supraventricular tachycardia (30%), atrial fibrillation (5%), ventricular tachycardia (10%), and ventricular fibrillation (5%) in comparison to the block group where atrial fibrillation occurred only in 4 patients (20%) with the value of 0.007. Mean arterial blood pressure and heart rate showed significantly lower values in the SGB group intraoperatively. Postoperative mean 24-hour inotropic score and hemodynamics showed insignificant differences.
Conclusion
Preoperative left stellate ganglion block can decrease incidence of arrhythmias during offpump coronary artery bypass graft surgeries. The technique showed a safe profile upon hemodynamics during the study period.

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Egyptian Journal of Anaesthesia
Volume 36, Issue 1
January 2020
Pages 194-200

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