Effects Of Right Stellate Ganglion Block On Perioperative New Atrial Fibrillation In Patients Undergoing Lobectomy

Objective:To observe the effects of preoperative right stellate ganglion block?RSGB?on perioperative atrial fibrillation in patients undergoing lobectomy,and explore its possible mechanisms and provide ideas for clinical prevention.Methods:The method of matching the preoperative age and risk factors of atrial fibrillation was adopted.200 patients who underwent a scheduled lobectomy were divided into the experimental group?n=100?and control group?n=100?.The experimental group was injected with 0.2%ropivacaine 4ml under ultrasound guidance,and the Horner syndrome on the injection side was determined as block.The control group did not receive stellate ganglion block.The incidences of new-onset atrial fibrillation and other types of arrhythmias were recorded from the start of surgery to 24 hours after surgery.The hemodynamic parameters of the patients were recorded at T₀?before anesthesia induction?,T₁?single lung ventilation?,T₂?single lung ventilation for 30 min?,T₃?single lung ventilation for 1 h?and T₄?double lung ventilation?.At the same time,we compared the changes of white blood cells after the lobectomy between the two groups in order to evaluate their inflammatory response.Results:1.There were no significant differences in gender,age,basic medical history,lung function and tumor location between the two groups?P>0.05?.There were no significant differences in urine volume,blood loss,fluid volume and operation time between the two groups?P>0.05?.2.Compared with T₀,the mean arterial pressure?MAP?of the patients at T₁^T₄group decreased.At T₂,the MAP of the experimental group was lower than that of the control group?P<0.05?.Compared with the T₀,heart rate of the experimental group?HR?)at T₂^T₄ significantly decreased?P<0.05?.However,HR stability of the experimental group was higher than that of the control group.3.The difference of white blood cells in the experimental group was lower than that in the control group?P<0.05?.4.The incidences of atrial fibrillation in the experimental group and the control group were 3%and 10%;the incidences of other atrial arrhythmias were 20%and38%;and the incidences of ventricular arrhythmia was 28%and 39%.The incidences of atrial fibrillation and other atrial arrhythmias in the experimental group were both lower than those in the control group?P<0.05?.There was no significant difference in the incidence of ventricular arrhythmia between the two groups?P>0.05?.Conclusion:Our study indicates that preoperative right stellate ganglion block?RSGB?can stabilize perioperative hemodynamics in patients with lobectomy,decrease inflammatory response,and effectively reduce the incidence of intraoperative and postoperative atrial fibrillation.