Postoperative stellate ganglion block reduces high-sensitivity troponin T release in patients undergoing off-pump coronary artery bypass surgery: a randomized controlled trial

BACKGROUND: The non-analgesic applications of stellate ganglion block (SGB) are increasingly garnering scholarly and clinical interest. This study aimed to investigate the myocardial protective effects of postoperative SGB in patients undergoing off-pump coronary artery bypass grafting (OPCABG). METHODS: In this double-blind, randomized controlled trial, 62 adults scheduled for OPCABG were randomized to one of two groups: the right stellate ganglion block group (RSGB group) and the control group. Postoperation, participants had a right SGB. However, controls were not blocked. The primary outcome was serum high-sensitivity troponin T concentration measured within seven days after surgery. Secondary outcomes included postoperative hemodynamics, postoperative pain scores, postoperative incidence of atrial fibrillation, postoperative dosage of vasoactive drugs, postoperative opioid consumption, incidence of myocardial infarction, 30-day postoperative mortality, and length of hospital stay. RESULTS: At some point after the operation, the RSGB group patients' serum high-sensitivity troponin levels were noticeably lower than the control group, with means (standard deviation [SD]) of 146.1 (49.7) vs. 207.8 (50.6) at 12 hours; 132.7 (35.6) vs. 202.6 (43.8) at 24 hours; 19.7 (9.2) vs. 41.7 (24.7) at seven days; all P<0.001. Moreover, the RSGB group showed significantly lower pain scores, a significantly reduced postoperative rate-pressure product (RPP) value, and a substantially lower incidence of atrial fibrillation. CONCLUSIONS: In patients undergoing OPCABG, it was observed that postoperative right SGB can reduce postoperative high-sensitivity cardiac troponin T levels.