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Can pre-operative left stellate ganglion block offer myocardial protection in on-pump mitral valve replacement? A histopathological and clinical assessment.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Control group | Placebo Comparator | Sonar guided stellate ganglion injection of 8 ml of sterile saline 0.9% using high frequency probe as a placebo. Stellate ganglion is identified at the level of C6 just under the pulsation of the ipsilateral carotid artery |
|
| Stellate ganglion | Active Comparator | Sonar guided stellate ganglion injection of 8ml bupivacaine 0.25% using high frequency probe. . Stellate ganglion is identified at the level of C6 just under the pulsation of the ipsilateral carotid artery |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| sonar guided stellate ganglion injection | Procedure | using high frequency probe, sonar guided stellate ganglion block with 8 ml saline 0.9% |
|
| Measure | Description | Time Frame |
|---|---|---|
| Number of patients with microscopic myocardial injury | Biopsy from left papillary muscle to investigate microscopic evidence of cellular injury ( cytoplasmic oedema, hemorrhage and necrosis). | intra-operative |
| Measure | Description | Time Frame |
|---|---|---|
| Intra-operative arrhythmia | incidence of intraoperative atrial fibrillation | intraoperatively |
| postoperative arrhythmia | Incidence of post operative atrial or ventricular arrhythmia |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Mina Raouf | Minya | Minya Governorate | 61511 | Egypt |
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| sonar guided stellate ganglion block | Procedure | using high frequency probe, sonar guided stellate ganglion block with 8 ml bupivacaine 0.25% |
|
| first, second and third day after bypass |
| Troponin I | Serum troponin I to diagnose myocardial injury | before operation, immediately after ICU admission and 3 days post-operative |
| Myocardial function | Ejection fraction | pre-operative, one week |
| weaning from mechanical ventilation | Time from ICU admission till successful extubation | 24 hours post-operative |
| Time of cardiopulmonary bypass | Intraoperative |
| Length of ICU stay | one week |
| Need for pacing | intraoperative and one week after |