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Post-operative new-onset atrial fibrillation (POAF) is one of the most common arrhythmias in adults after direct intracardiac surgery with extracorporeal circulation. The incidence of POAF in coronary artery bypass grafting (CABG) is approximately 30%. POAF can lead to an increased risk of complications such as stroke, heart failure, and acute kidney injury, which not only prolongs the patient's hospital stay, but also increases hospital costs and mortality. operation, extracorporeal circulation, and the patient's underlying conditions (such as age, gender, hypertension, and diabetes), which cause sympathetic activation, inflammatory response, and myocardial ischemia in the organism. The stellate ganglion block (SGB) regulates the sympathetic tone of the innervated nerves and thus the autonomic function of the body. SGB can effectively regulate the sympathetic-parasympathetic imbalance. Also, SGB may exert some anti-inflammatory effects. In this study, ultrasound-guided SGB was used in CABG patients to investigate its effect on the occurrence of POAF.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Left stellate ganglion block | Experimental | Left stellate ganglion block under ultrasound guidance was administered with 0.375% Ropivacaine hydrochloride 5 ml |
|
| Control | No Intervention | do nothing |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Stellate nerve block | Procedure | Before the operation, the left stellate ganglion block was performed, and 0.375% ropivacaine 5ml was injected into the stellate ganglion. |
|
| Measure | Description | Time Frame |
|---|---|---|
| The occurrence of new atrial fibrillation was detected by ECG monitoring | ECG monitor shows atrial fibrillation. To be specific: 1)Irregular R-R interval (when atrioventricular conduction is present), 2) P wave disappearance, 3) irregular atrial activity. | Within 5 days after surgery |
| Measure | Description | Time Frame |
|---|---|---|
| AF burden | The percentage of the time during which atrial fibrillation occurs in the overall recorded time. | within 5 days after surgery |
| Duration of the first episode of POAF | The duration from the onset to the resolution of the first atrial fibrillation after surgery. |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| the Affiliated Hospital of Yangzhou University, Yangzhou University | Yangzhou | Jiangsu | China |
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| within 5 days after surgery |
| Need for Antiarrhythmic treatments | Record the types of medications used and whether electrical cardioversion has been used. | within 5 days after the operation |
| the concentration of interleukin-6 | Interleukin-6 (IL-6) is an important cytokine that plays a key role in immune responses, inflammation, and tumor development. | end of surgery, 24 hour postoperatively, 72hour postoperatively, 5 day postoperatively |
| the concentration of CRP | C-reactive protein (CRP) is a protein produced by the liver that is mainly used to indicate the presence of inflammation in the body. | end of surgery,24 hour postoperatively ,72 hour postoperatively ,5 day postoperatively |
| Changes of intraoperative Left ventricular diastolic function | Left ventricular diastolic function were measured by transesophageal echocardiography (TEE) | T1 (after sternotomy and before CPB) and T2 (30 minute after CPB cessation). |
| the concentration of Hs-cTnT | hs-cTnT is an important biomarker used for detecting cardiac injury. | end of surgery, 24hour postoperatively, 72hour postoperatively |
| the concentration of CK-MB | CK-MB is an enzyme primarily found in cardiac muscle cells. Its concentration is commonly used to assess cardiac damage, especially in the case of myocardial infarction | end of surgery, 24hour postoperatively, 72hour postoperatively |
| postoperative adverse reactions | Record the occurrence of adverse reactions postoperative | From date of randomization until the date of first documented progression or date of death from any cause, whichever came first, assessed up to 100 months |