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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
TRIPLE
Enrollment
108
Before the operation, the left stellate ganglion block was performed, and 0.375% ropivacaine 5ml was injected into the stellate ganglion.
the Affiliated Hospital of Yangzhou University, Yangzhou University
Yangzhou, Jiangsu, China
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.
Time frame: Within 5 days after surgery
AF burden
The percentage of the time during which atrial fibrillation occurs in the overall recorded time.
Time frame: within 5 days after surgery
Duration of the first episode of POAF
The duration from the onset to the resolution of the first atrial fibrillation after surgery.
Time frame: within 5 days after surgery
Need for Antiarrhythmic treatments
Record the types of medications used and whether electrical cardioversion has been used.
Time frame: within 5 days after the operation
the concentration of interleukin-6
Interleukin-6 (IL-6) is an important cytokine that plays a key role in immune responses, inflammation, and tumor development.
Time frame: end of surgery, 24 hour postoperatively, 72hour postoperatively, 5 day postoperatively
the concentration of CRP
C-reactive protein (CRP) is a protein produced by the liver that is mainly used to indicate the presence of inflammation in the body.
Time frame: end of surgery,24 hour postoperatively ,72 hour postoperatively ,5 day postoperatively
Changes of intraoperative Left ventricular diastolic function
Left ventricular diastolic function were measured by transesophageal echocardiography (TEE)
Time frame: T1 (after sternotomy and before CPB) and T2 (30 minute after CPB cessation).
the concentration of Hs-cTnT
hs-cTnT is an important biomarker used for detecting cardiac injury.
Time frame: end of surgery, 24hour postoperatively, 72hour postoperatively
the concentration of CK-MB
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
Time frame: end of surgery, 24hour postoperatively, 72hour postoperatively
postoperative adverse reactions
Record the occurrence of adverse reactions postoperative
Time frame: 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
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