Efficacy of Stellate Ganglion Block for Preventing Postoperative Atrial Fibrillation After Cardiac Surgery: A Randomized, Double-Blind, Placebo-Controlled Trial
In brief
Stellate ganglion block did not lower atrial fibrillation: 43% vs 40%
In a randomized trial of 132 patients undergoing valve surgery, preoperative stellate ganglion block did not reduce postoperative atrial fibrillation: it occurred in 43% of treated patients and 40% of those given saline. Treated patients had fewer episodes of ventricular arrhythmia requiring defibrillation and less acute kidney injury, but these secondary findings need confirmation.
- Journal
- Journal of the American Heart Association (Q1)
- Published
- 30 October 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Jun Zhang, Yeru Chen, Nuan Li, Zhichao Ai, Jingwen Liang, Yi Chen, et al.
- PMID
- 42960736
- DOI
- 10.1161/JAHA.126.051373
Why clinicians should know about it
- Picked for Anesthesiology and Pain Medicine (top studies of the week, 8 November 2026): Randomized trial of regional block and perioperative cardiac outcomes
Abstract
BACKGROUND: Stellate ganglion block (SGB) may reduce postoperative atrial fibrillation (POAF) by modulating the autonomic nervous system. This study evaluated the efficacy of preoperative SGB in preventing POAF following cardiac surgery. METHODS: In this single-center, randomized, double-blind, placebo-controlled trial, 140 patients undergoing valve surgery with cardiopulmonary bypass were assigned (1:1) to ultrasound-guided right SGB with 7 mL of 0.5% ropivacaine or 7 mL of normal saline. The primary outcome was the incidence of POAF from postoperative day 0 to day 7 or until discharge. RESULTS: A total of 132 patients completed the study and were included in the modified intention-to-treat population (SGB group: n=65; saline group: n=67). POAF occurred in 43% of the SGB group and 40% of the saline group (odds ratio [OR], 0.99 [95% CI, 0.46-2.15], adjusted P=0.989). The SGB group demonstrated a lower incidence of intraoperative ventricular fibrillation/ventricular tachycardia requiring defibrillation after aortic cross-clamp release (6% versus 19%; OR, 0.21 [95% CI, 0.06-0.80]; adjusted P=0.022), lower postoperative high-sensitivity troponin I levels (median difference: -2562 ng/L [95% CI, -4301 to -45]; P=0.045), and a reduced risk of postoperative acute kidney injury (5% versus 18%; OR, 0.24 [95% CI, 0.06-0.98]; adjusted P=0.046). CONCLUSIONS: While preoperative SGB did not reduce the incidence of POAF, it was associated with potential benefits, including a lower requirement for intraoperative defibrillation attributable to ventricular arrhythmias, attenuated myocardial injury (as indicated by lower high-sensitivity troponin I levels), and a decreased risk of postoperative acute kidney injury. REGISTRATION: URL: https://www.chictr.org.cn; URL Identifier: ChiCTR2300068572.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.