SGB Reduces the Incidence and Severity of CSA-AKI

Yangzhou University

Status: Completed

Conditions: Stellate Ganglion Block

Treatments: Drug: Stellate ganglion block

Study type: Interventional

Funder types: Other

Identifiers

NCT05652179

20221107

Details and patient eligibility

About

The incidence of acute kidney injury after cardiopulmonary bypass cardiac surgery is high, which increases postoperative mortality and is not conducive to the prognosis of patients. Stellate ganglion blocks increase renal blood flow, reduce inflammation and stress, and protect the heart muscle. In this study, stellate ganglion block was used to promote rapid recovery of kidney function after cardiopulmonary bypass cardiac surgery.

Enrollment: 396 patients

Sex: All

Ages: 18 to 80 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. Patients of any gender were eligible provided they were between the ages of 18 and 80 years;
2. American Society of Anesthesiologists (ASA) class of Ⅲ or IV.

Exclusion criteria

1. emergency cardiac surgery；
2. major vascular surgery；
3. non-sinus rhythm, reoperation；
4. contraindications for TEE or SGB；
5. abnormal preoperative renal function；
6. severe preoperative heart failure with left ventricular ejection fraction < 30%, multi-organ dysfunction；
7. and severe infection requiring continuous antibiotic treatment;
8. enrolled in another clinical trial.

Elimination criteria:

1. incomplete follow-up data;
2. withdrawal during the procedure;
3. SGB failure or complications;
4. insufficient ultrasonographic imaging of the left renal artery on TEE;
5. repeated CPB during surgery;
6. need for cardiac assist devices (extracorporeal membrane oxygenation, intra-aortic balloon pump, or ventricular assist devices) after CPB completion.

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Quadruple Blind

---

396 participants in 2 patient groups

Stellate ganglion block

Experimental group

Description:

For patients in Group S, left SGB was performed after the first TEE examination. The patient's head was tilted to the right. A high-frequency probe (6-13 MHz) was placed between the C6 and C7 transverse processes to obtain the best image of the longus colli muscle. After iodine disinfection, a 22-G atraumatic needle for peripheral nerve blocks (B. Braun Melsungen AG, Melsungen, Germany) was used to puncture the site posterior to the left carotid artery and on the surface of the longus colli muscle via an in-plane technique. Then,5 mL of 0.375% ropivacaine hydrochloride injection was administered provided that no blood, cerebrospinal fluid, or gas was suctioned out

Treatment:

Drug: Stellate ganglion block

Control

No Intervention group

Description:

Patients in Group C did not undergo the SGB procedure.