Effect of Stellate Ganglion Block on New Atrial Fibrillation After Coronary Artery Bypass Grafting

Study Overview
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Brief Summary
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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.

Official Title
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Effect of Stellate Ganglion Block on New Atrial Fibrillation After Coronary Artery Bypass Grafting

Conditions
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Stellate Ganglion Block

Intervention / Treatment
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* Procedure: Stellate nerve block


Participation Criteria
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Eligibility Criteria
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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.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Left stellate ganglion block<br>Left stellate ganglion block under ultrasound guidance was administered with 0.375% Ropivacaine hydrochloride 5 ml | Procedure: Stellate nerve block<br>* Before the operation, the left stellate ganglion block was performed, and 0.375% ropivacaine 5ml was injected into the stellate ganglion.<br>|
| No Intervention: Control<br>do nothing | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The occurrence of new atrial fibrillation was detected by ECG monitoring | 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. | Within 5 days after surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Changes in the inflammatory factor interleukin-6 | Detection of inflammatory factors by serum，It reflects the degree of inflammation in the body at different time points | Preoperatively, End of operation ，The first day after surgery, The Third day after surgery | 
| Changes in the Stress index cortisol | Detection of Stress index by serum，It reflects the degree of stress in the body at different time points | Preoperatively, End of operation ，The first day after surgery, The Third day after surgery |