Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjane.2020.04.024
Brazilian Journal of Anesthesiology
Clinical Research

Effect of ultrasound-guided right stellate ganglion block on perioperative atrial fibrillation in patients undergoing lung lobectomy: a randomized controlled trial

Efeito do bloqueio do gânglio estrelado direito guiado por ultrassom na fibrilação atrial perioperatória em pacientes submetidos a lobectomia pulmonar: estudo controlado randomizado

Ru Ouyang, Xinrui Li, Rui Wang, Qiqi Zhou, Yali Sun, Enjun Lei

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Abstract

Objective
To observe the effects of preoperative right stellate ganglion block on perioperative atrial fibrillation in patients undergoing lung lobectomy.

Methods
Two hundred patients who underwent a scheduled lobectomy were randomly divided into the S and C groups. The S group was injected with 4 mL of 0.2% ropivacaine under ultrasound guidance, and the C group did not receive stellate ganglion block. The patients underwent continuous ECG monitoring, and the incidences of atrial fibrillation and other types of arrhythmias were recorded from the start of surgery to 24 hours after surgery.

Results
The respective incidences of atrial fibrillation in the S group and the C group were 3% and 10% (p =  0.045); other atrial arrhythmias were 20% and 38% (p =  0.005); and ventricular arrhythmia were 28% and 39% (p =  0.09).

Conclusions
The results of the study indicated that preoperative right stellate ganglion block can effectively reduce the incidence of intraoperative and postoperative atrial fibrillation.

Keywords

Atrial fibrillation;  Lobectomy;  Autonomic function;  Stellate ganglion block

Resumo

Objetivo
Observar os efeitos do bloqueio do gânglio estrelado na fibrilação atrial no período perioperatório em pacientes submetidos a lobectomia pulmonar.

Método
Duzentos pacientes programados para lobectomia foram divididos aleatoriamente nos grupos S e C. O grupo S recebeu infusão de 4 mL de ropivacaína a 0,2% orientada por ultrasom e o grupo C não foi submetido a bloqueio do gânglio estrelado. Os pacientes foram submetidos à monitoração contínua de ECG, e as incidências de fibrilação atrial e outros tipos de arritmias foram registradas do início da cirurgia até 24 horas depois da cirurgia.

Resultados
As incidências de fibrilação atrial no grupo S e no grupo C foram 3% e 10%, respectivamente (p =  0,045); as de outras arritmias atriais foram 20% e 38% (p =  0,005); e de arritmias ventriculares 28% e 39% (p =  0,09).

Conclusões
Os resultados do estudo indicaram que o bloqueio do gânglio estrelado no pré-operatório pode ser efetivo na redução da incidência de fibrilação atrial nos períodos intra- e pós-operatório.

Palavras-chave

Fibrilação atrial;  Lobectomia;  Função autonômica;  Bloqueio do gânglio estrelado

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