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Stellate Ganglion Block Can Cause Enhanced Recovery After Coronary Arteries Bypass Grafting Surgery

Not Applicable
Completed
Conditions
Ischemic Heart Disease
Interventions
Other: ultrasound guided left stellate ganglion block
Registration Number
NCT04439058
Lead Sponsor
wail abdelaal
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).

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
40
Inclusion Criteria

Ischemic heart disease patients age above 18 years

Exclusion Criteria

allergy to LA, severe COPD

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Bupivacaine+lignocaineultrasound guided left stellate ganglion blockwill receive ultrasound guided left stellate ganglion block just after induction of anesthesia with10 ml of bupivacaine 0,25%+ 5ml lignocaine 1%(20 patients). Under complete aseptic precautions an ultrasound guided left stellate ganglion block (paratracheal technique ) The patient placed in the supine position with the head in the neutral position and slightly extended. The US probe placed at the level of the cricoid cartilage. The transverse process of the sixth cervical vertebra identified by its prominent anterior tubercle. Also, the longus colli muscle and its overlying prevertebral fascia anterior to the C6 vertebral body and deep to the carotid artery. skin infiltration with local anesthetic, the needle 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
Normal salineultrasound guided left stellate ganglion blockwill receive ultrasound guided left stellate ganglion block just after induction of anesthesia with 15 ml of normal saline (20 patients). 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
Primary Outcome Measures
NameTimeMethod
change in cardiac rhythmchange in cardiac rhythm from base line

incidence of AF or VF(BPM)

change in Ejection Fractionchange in Ejection Fraction from base line

Ejection Fraction(%)

change in blood pressurechange in blood pressure from base line

MAP, Systemic arterial pressure ( mmHg )

change in heart ratechange in heart rate from base line

heart rate( bpm )

Secondary Outcome Measures
NameTimeMethod
effect of preoperative stellate ganglion block on enhanced recovery after coronary arteries bypass grafting surgerychange of troponin level from base line

measuring troponin level (ng/ml)

Trial Locations

Locations (1)

Wail Abdelaal

🇪🇬

Cairo, Egypt

Wail Abdelaal
🇪🇬Cairo, Egypt
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