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

• Published in: Acta anaesthesiologica Scandinavica 2007-04, Vol.51 (4), p.434-440
• Main Authors: Yildirim, V., Akay, H. T., Bingol, H., Bolcal, C., Iyem, H., Doğanci, S., Demirkilic, U., Tatar, H.
• Format: Article
• Language: English
• Subjects: Amides - administration & dosage; Analysis of Variance; Anesthesia; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Anesthetics, Local - administration & dosage; Biological and medical sciences; Coronary Artery Bypass - methods; coronary bypass; Coronary Disease - surgery; Coronary Vasospasm - prevention & control; Female; graft patency; Humans; Male; Medical sciences; Middle Aged; Nerve Block - methods; Postoperative Complications - prevention & control; Prospective Studies; radial artery; Radial Artery - diagnostic imaging; Radial Artery - drug effects; Radial Artery - transplantation; Radiography; Regional Blood Flow - drug effects; Stellate Ganglion - drug effects; stellate ganglion block; Vascular Patency - drug effects; vasospasm
• ISSN: 0001-5172; 1399-6576
• DOI: 10.1111/j.1399-6576.2006.01260.x

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.