• Cai-Neng Wu, Xin-Hai Wu, Dong-Nan Yu, Wu-Hua Ma, Chun-Hui Shen, and Ying Cao.
• From the Department of Anaesthesiology, First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou (C-NW, W-HM), Department of Anesthesiology, Peking University Shenzhen Hospital, Shenzhen (W-HW), Department of Anesthesiology, Guangdong Provincial People's Hospital (D-NY), Department of Thoracic Surgery, First Affiliated Hospital of Guangzhou University of Chinese Medicine (C-HS) and Department of Cardiovascular Pharmacology, School of Pharmacological Science, Southern Medical University, Guangzhou, China (YC).
• Eur J Anaesthesiol. 2020 Apr 1; 37 (4): 323-331.

BackgroundNew-onset arrhythmias and sleep disturbances are frequently observed during the postoperative period in patients undergoing thoracic surgery.ObjectiveWe evaluated the effectiveness of a single-dose stellate ganglion block (SGB) to prevent the occurrence of arrhythmias in patients undergoing thoracic surgery for cancer.DesignRandomised controlled double-blind study.SettingSingle university hospital.PatientsNinety patients with lung cancer or oesophagal cancer scheduled for elective video-assisted thoracoscopic surgery were randomly randomised into one of two equal groups (the SGB group and control group, n = 40 each).InterventionsPatients received a single dose of 5 ml of 0.5% ropivacaine during ultrasound-guided SGB before induction of general anaesthesia in the SGB group.Main Outcome MeasuresHolter ECG was continuously monitored during the first 48 postoperative hours, and sleep state was monitored during the first two postoperative nights.ResultsThe incidences of postoperative supraventricular tachycardias were lower in the SGB group compared with the control group during the first 48 postoperative hours; 11.6 (5/43) vs. 31.8% (14/44), respectively, P = 0.023 (odds ratio 0.28, 95% confidence interval 0.09 to 0.87). The SGB also prolonged the total sleep time and increased the sleep efficiency during the first two postoperative nights. The duration of stage N2 sleep was longer in the SGB group compared with the control group [28 (interquartile range, 14 to 58) to 94 (interquartile range, 69 to 113) min, P = 0.016] on the first postoperative night. There were no differences in the duration of stage N1 and N3 sleep (P = 0.180, 0.086, respectively) on the first postoperative night, and the duration of stage N1, N2 and N3 sleep (P = 0.194, 0.057, 0.405, respectively) on the second postoperative night between the groups.ConclusionA pre-operative SGB effectively prevented the occurrence of postoperative supraventricular tachycardias and improves the objective sleep quality in patients undergoing thoracic surgery for cancer.Trial Registration NumberChiCTR-1900023064.

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