Pre-emptive stellate ganglion block increases the patency of radial artery grafts in coronary artery bypass surgery

Acta Anaesthesiol Scand. 2007 Apr;51(4):434-40. doi: 10.1111/j.1399-6576.2006.01260.x.

Abstract

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.

Conclusion: 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.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Amides / administration & dosage
  • Analysis of Variance
  • Anesthetics, Local / administration & dosage
  • Coronary Artery Bypass / methods*
  • Coronary Disease / surgery
  • Coronary Vasospasm / prevention & control
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nerve Block / methods*
  • Postoperative Complications / prevention & control
  • Prospective Studies
  • Radial Artery / diagnostic imaging
  • Radial Artery / drug effects*
  • Radial Artery / transplantation
  • Radiography
  • Regional Blood Flow / drug effects
  • Ropivacaine
  • Stellate Ganglion / drug effects*
  • Vascular Patency / drug effects*

Substances

  • Amides
  • Anesthetics, Local
  • Ropivacaine