Pre-emptive stellate ganglion block increases the patency of radial artery grafts in coronary artery bypass surgery.
BACKGROUND
We evaluated the role of pre-emptive stellate ganglion block (SGB) in preventing radial artery spasm and increasing radial artery graft patency in patients undergoing off-pump coronary artery bypass surgery.


METHODS
In this prospective randomized study, 100 patients were divided into two equal groups (n= 50). In group A, SGB was achieved using 10 ml of ropivacaine and, in group B, SGB was not performed. Radial artery blood flow was measured pre- and intra-operatively. Post-operative clinical determinants (S-T segment elevation, use of inotropic agents, incidence of atrial fibrillation) were recorded. Early coronary angiography was performed.


RESULTS
According to blood flowmeter measurements, the radial artery blood flow was significantly increased in patients with SGB. The incidence of atrial fibrillation, the need for inotropic agents and S-T segment elevation were all decreased in the SGB group. Angiographic intervention revealed that the incidence of graft spasm was also lower in the SGB group.


CONCLUSIONS
Pre-emptive SGB is an effective method for increasing radial artery blood flow and preventing radial artery spasm. Complications related to radial artery spasm may be decreased and patients may have a more comfortable post-operative period with this method.
Yildirim
V
V
Department of Anesthesiology and Reanimation, Gulhane Military Medical Academy, Ankara, Turkey.
Akay
H T
HT
Bingol
H
H
Bolcal
C
C
Iyem
H
H
Doğanci
S
S
Demirkilic
U
U
Tatar
H
H
D000577:Amides / Q000008:administration & dosage; D000704:Analysis of Variance; D000779:Anesthetics, Local / Q000008:administration & dosage; D001026:Coronary Artery Bypass / Q000379:methods*; D003327:Coronary Disease / Q000601:surgery; D003329:Coronary Vasospasm / Q000517:prevention & control; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control; D011446:Prospective Studies; D017534:Radial Artery / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000637:transplantation; D011859:Radiography; D012039:Regional Blood Flow / Q000187:drug effects; D000077212:Ropivacaine; D013233:Stellate Ganglion / Q000187:drug effects*; D014654:Vascular Patency / Q000187:drug effects*
D000577:Amides; D000779:Anesthetics, Local; D000077212:Ropivacaine