Can pre-operative left stellate ganglion block offer myocardial protection in on-pump mitral valve replacement? A histopathological and clinical assessment.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
DOUBLE
Enrollment
100
using high frequency probe, sonar guided stellate ganglion block with 8 ml saline 0.9%
using high frequency probe, sonar guided stellate ganglion block with 8 ml bupivacaine 0.25%
Number of patients with microscopic myocardial injury
Biopsy from left papillary muscle to investigate microscopic evidence of cellular injury ( cytoplasmic oedema, hemorrhage and necrosis).
Time frame: intra-operative
Intra-operative arrhythmia
incidence of intraoperative atrial fibrillation
Time frame: intraoperatively
postoperative arrhythmia
Incidence of post operative atrial or ventricular arrhythmia
Time frame: first, second and third day after bypass
Troponin I
Serum troponin I to diagnose myocardial injury
Time frame: before operation, immediately after ICU admission and 3 days post-operative
Myocardial function
Ejection fraction
Time frame: pre-operative, one week
weaning from mechanical ventilation
Time from ICU admission till successful extubation
Time frame: 24 hours post-operative
Time of cardiopulmonary bypass
Time frame: Intraoperative
Length of ICU stay
Time frame: one week
Need for pacing
Time frame: intraoperative and one week after
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