الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
SUMMARY
arge number of patients undergo coronary artery bypass
grafting (CABG) each year worldwide. Recently, there
have been major advances in techniques used in CABG surgery
in order to assure better success rates and reduce complication
rates. Thus, there has been a move toward newer methods such
as minimal access and off cardiopulmonary bypass (CPB)
surgery are now in routine practice in many centers around the
world to reduce the rates of postoperative morbidity and length
of hospital stay. Despite such advances, patients that present for
CABG surgery nowadays are relatively older and frailer with
multiple cardiopulmonary and other comorbidities as compared
to patients operated on in the last century. Therefore, the risk of
significant post-operative morbidity and mortality still exists.
The stellate ganglion is an important part of the
sympathetic network formed by the inferior cervical and first
thoracic ganglia. It receives input from the paravertebral
sympathetic chain and provides sympathetic efferents to the
upper extremities, head, neck, and heart.
The cervical sympathetic chain is composed of the fusion
of superior, middle, and inferior cervical ganglia. In about 80% of
the population, the inferior cervical ganglion fuses with the first
thoracic ganglion, forming the cervico-thoracic ganglion also
known as the stellate ganglion.
L
Summary
76
Using the image-guidance in stellate ganglion blocks have
the advantages of increased safety and accuracy compared with
blind injections. The needle could be accurately placed near the
stellate ganglion, and, as a result, a safer and smaller amount of
local anesthetic can be used, reducing the risk of adverse effects.
Stellate ganglion block has traditionally been performed
blindly by palpating the anterior tubercle of the transverse
process of C6 (Chassaignac tubercle) and infiltrating a volume
(as much as 10 mL) of local anesthetic to result in an effective
block.This method has a relatively high failure rate, with
numerous significant and even potentially fatal adverse effects.
The aim of this study is to observe and record the
incidence of occurrence of postoperative hypertension, cardiac
arrhythmias, and ischemia in patients group that had been
received a SGB, and in the other control group of cardiac
surgery patients without block.
The study included 90 patients, aged 18-60 years, of
either sex who underwent elective cardiac surgeries.
In the present study, patients were randomly divided into
2 equal groups, 45 patients each. group B, that had been
received stellate ganglion block (study group), and group C,
which did not received block (control group).
The current study showed that the dose of inotrops
(Epinephrine and Nor-epinephrine) needed intra-operatively
Summary
77
and post-operatively were significantly lower in the SGB
group in comparison with control Group. In addition, the dose
of Nitroglycerine needed both during surgery and postoperatively
was significantly lower in the SGB group. On the
other hand, there was no significant difference in the incidence
of new arrhythmias and need for anti-arrhythmic intervensions
needed in SGB group