Europace

, volume 26 , issue 4

Continuous stellate ganglion block for ventricular arrhythmias: case series, systematic review, and differences from thoracic epidural anaesthesia

Veronica Dusi ^{1, 2}

Filippo Angelini ²

Enrico Baldi ³

Antonio Toscano ⁴

Carol Gravinese ²

Simone Frea ²

Sara Compagnoni ⁵

Arianna Morena ^{1, 2}

Andrea Saglietto ²

Eleonora Balzani ⁶

Matteo Giunta ⁴

Andrea Costamagna ⁴

Mauro Rinaldi ^{6, 7}

Anna Chiara Trompeo ⁴

Roberto Rordorf ³

Matteo Anselmino ^{1, 2}

Simone Savastano ³

G M De Ferrari ^{1, 2}

Hide authors affiliations Show authors affiliations: 7 affiliations

Cardiology, Department of Medical Sciences, University of Turin , Corso Dogliotti 14, 10126 Torino , Italy |

Division of Cardiology, Cardiovascular and Thoracic Department, ‘Città della Salute e della Scienza’ Hospital , Corso Bramante 88/90, 10126 Torino , Italy |

Arrhythmia and Electrophysiology Unit, Division of Cardiology, Fondazione IRCCS Policlinico San Matteo , Pavia , Italy |

⁴

Department of Anaesthesia, Critical Care and Emergency, ‘Città della Salute e della Scienza’ Hospital , Torino , Italy |

⁵

Department of Molecular Medicine, Section of Cardiology, University of Pavia , Viale Golgi 19, 27100 Pavia , Italy |

⁶

Department of Surgical Sciences, University of Turin , Torino , Italy |

⁷

Department of Cardiovascular and Thoracic Surgery, ‘Città della Salute e della Scienza’ Hospital , Torino , Italy |

Publication type: Journal Article

Publication date: 2024-03-26

Oxford University Press

Europace

scimago Q1

wos Q1

SJR: 3.057

CiteScore: 12.6

Impact factor: 7.4

ISSN: 10995129, 15322092

DOI: 10.1093/europace/euae074

Copy DOI

PubMed ID: 38531027

Cardiology and Cardiovascular Medicine

Physiology (medical)

Abstract

Background

Percutaneous stellate ganglion block (PSGB) through single bolus injection and thoracic epidural anaesthesia (TEA) have been proposed for the acute management of refractory ventricular arrhythmias (VAs). However, data on continuous PSGB (C-PSGB) are scant.

Aims

To report our dual-center experience with C-PSGB and to perform a systematic review on C-PSGB and TEA.

Methods

Consecutive patients receiving C-PSGB at 2 centers were enrolled. The systematic literature review follows the latest PRISMA criteria.

Results

Our case series (26 patients, 88% male, 60±16 years, all with advanced structural heart disease, LVEF 23±11%, 32 C-PSGB performed, median duration 3 days) shows that C-PSGB is feasible and safe and leads to complete VAs suppression in 59% and to overall clinical benefit in 94% of cases. Overall, 61 patients received 68 C-PSGB and 22 TEA, with complete VAs suppression in 63% of C-PSGBs (61% of patients). Most TEA procedures (55%) were performed on intubated patients, as opposed to 28% C-PSGBs (p=0.02); 52% of patients were on full anticoagulation at C-PSGB, none at TEA (p<0.001). Ropivacaine and lidocaine were the most used drugs for C-PSGB, and the available data support a starting dose of 12 mg/h and 100 mg/h, respectively. No major complications occurred, yet TEA discontinuation rate due to side-effects was higher than C-PSGB (18% versus 1%, p=0.01).

Conclusions

C-PSGB seems feasible, safe, and effective for the acute management of refractory VAs. The antiarrhythmic effect may be accomplished with less concerns for concomitant anticoagulation compared to TEA, and with a lower side-effects related discontinuation rate.

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GOST |

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GOST Copy

Dusi V. et al. Continuous stellate ganglion block for ventricular arrhythmias: case series, systematic review, and differences from thoracic epidural anaesthesia // Europace. 2024. Vol. 26. No. 4.

GOST all authors (up to 50) Copy

Dusi V., Angelini F., Baldi E., Toscano A., Gravinese C., Frea S., Compagnoni S., Morena A., Saglietto A., Balzani E., Giunta M., Costamagna A., Rinaldi M., Trompeo A. C., Rordorf R., Anselmino M., Savastano S., De Ferrari G. M. Continuous stellate ganglion block for ventricular arrhythmias: case series, systematic review, and differences from thoracic epidural anaesthesia // Europace. 2024. Vol. 26. No. 4.

RIS |

Cite this

RIS Copy

TY - JOUR

DO - 10.1093/europace/euae074

UR - https://doi.org/10.1093/europace/euae074

TI - Continuous stellate ganglion block for ventricular arrhythmias: case series, systematic review, and differences from thoracic epidural anaesthesia

T2 - Europace

AU - Dusi, Veronica

AU - Angelini, Filippo

AU - Baldi, Enrico

AU - Toscano, Antonio

AU - Gravinese, Carol

AU - Frea, Simone

AU - Compagnoni, Sara

AU - Morena, Arianna

AU - Saglietto, Andrea

AU - Balzani, Eleonora

AU - Giunta, Matteo

AU - Costamagna, Andrea

AU - Rinaldi, Mauro

AU - Trompeo, Anna Chiara

AU - Rordorf, Roberto

AU - Anselmino, Matteo

AU - Savastano, Simone

AU - De Ferrari, G M

PY - 2024

DA - 2024/03/26

PB - Oxford University Press

IS - 4

VL - 26

PMID - 38531027

SN - 1099-5129

SN - 1532-2092

ER -

BibTex

Cite this

BibTex (up to 50 authors) Copy

@article{2024_Dusi,

author = {Veronica Dusi and Filippo Angelini and Enrico Baldi and Antonio Toscano and Carol Gravinese and Simone Frea and Sara Compagnoni and Arianna Morena and Andrea Saglietto and Eleonora Balzani and Matteo Giunta and Andrea Costamagna and Mauro Rinaldi and Anna Chiara Trompeo and Roberto Rordorf and Matteo Anselmino and Simone Savastano and G M De Ferrari},

title = {Continuous stellate ganglion block for ventricular arrhythmias: case series, systematic review, and differences from thoracic epidural anaesthesia},

journal = {Europace},

year = {2024},

volume = {26},

publisher = {Oxford University Press},

month = {mar},

url = {https://doi.org/10.1093/europace/euae074},

number = {4},

doi = {10.1093/europace/euae074}

}

Publisher

Oxford University Press

Journal

Europace

scimago Q1

wos Q1

SJR

3.057

CiteScore

12.6

Impact factor

7.4

ISSN

10995129 (Print)

15322092 (Electronic)

Profiles

Roberto Rordorf