Preoperative left stellate ganglion block: Does it offer arrhythmia-protection during off-pump CABG surgery? A randomized clinical trial

Background Cardiac arrhythmias are not uncommon during and after coronary artery bypass graft cardiac surgeries. Preliminary studies showed the preventive effects of stellate ganglion block upon cardiac arrhythmias; however, this could be the 1st study focusing upon intraoperative arrhythmias during offpump coronary artery bypass graft surgery as a main goal.Methods This is a randomized controlled trial. The study involved forty adult patients undergoing elective offpump coronary artery bypass graft surgery. Twenty patients received left SGB with 10 ml of 2% lidocaine before induction of anesthesia (B group), and twenty patients as a control group (A group). Intraoperative and 24-hours postoperative electrocardiogram and hemodynamics were monitored, in addition to the mean postoperative 24-hours inotropic score.Results There was a significantly higher incidence of intraoperative arrhythmias in the control group in the form of bradyarrhythmia (25%), supraventricular tachycardia (30%), atrial fibrillation (5%), ventricular tachycardia (10%), and ventricular fibrillation (5%) in comparison to the block group where atrial fibrillation occurred only in 4 patients (20%) with the p value of 0.007. Mean arterial blood pressure and heart rate showed significantly lower values in the SGB group intraoperatively. Postoperative mean 24-hour inotropic score and hemodynamics showed insignificant differences.Conclusion Preoperative left stellate ganglion block can decrease incidence of arrhythmias during offpump coronary artery bypass graft surgeries. The technique showed a safe profile upon hemodynamics during the study period.