• Roshith Chandran, Rupa Sreedhar, Shrinivas Gadhinglajkar, Prashantkumar Dash, Jayakumar Karunakaran, and Vivek Pillai.
• Department of Cardiac Anaesthesia, Freeman Hospital, Newcastle Upon Tyne, UK.
• Ann Card Anaesth. 2020 Apr 1; 23 (2): 170-176.

BackgroundLeft stellate ganglion blockade (LSGB) may have additive effect to topical administration of papaverine on prevention of vasospasm of left internal thoracic artery (LITA).AimsThis study aims to compare LITA blood flow with topical application of papaverine alone or in combination with LSGB.SettingTertiary care hospital.DesignProspective randomized controlled study.Materials And MethodsA total of 100 patients operated for coronary revascularization were randomly and equally allocated into two groups. In control Group-C, papaverine was applied topically during the dissection of LITA. In Group-S, the additional LSGB was performed. Blood flow was measured from cut end of the LITA for 15 s. Primary objectives of the evaluation were to observe differences in the LITA blood flow. Observing incidence of radial-femoral arterial pressure difference after cardiopulmonary bypass (CPB) was secondary objective.Statistical AnalysisStudent's unpaired t-test and Fisher's exact test to find out a significant difference between the groups.ResultsLITA flow in Group-S was insignificantly more (49.28 ± 7.88 ml/min) than Group-C (47.12 ± 7.24 ml/min), (P = 0.15). Radio-femoral arterial pressure difference remained low for 40 min after termination of CPB in the Group-S compared to the Group-C (-0.99 ± 1.85 vs. -1.92 ± 2.26).ConclusionCombining LSGB with papaverine does not increase the LITA blood flow compared to when the papaverine is used alone. However, ganglion blockade reduces radial-femoral arterial pressure difference after CPB. Blockade can be achieved successfully under the ultrasound guidance without any complications.

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