Clinical Research Directory

Inclusion Criteria: 1. All elderly (≥65 years) patients of both genders, as according to the World Health Organization, the chronologic age of 65 years was accepted by most developed countries in the world as a definition of "elderly" or older person. Patients scheduled for elective cardiac surgery under general anesthesia.14 2. American Society of Anesthesiologists (ASA) physical status class II or III. 3. Patients will be stratified according to their baseline surgical risk utilizing the EuroSCORE II tool \>4%15. 4. American Society of Anesthesiologists (ASA) physical status class II or III. Exclusion Criteria: 1. Pre-existing dementia or significant cognitive impairment. 2. History of stroke or cerebrovascular disease. 3. Contraindications to SGB (e.g., coagulopathy, local infection, or anatomical abnormalities). 4. Preoperative use of antipsychotics or antidepressants. 5. Sinus bradycardia \<50bpm \&complete heart block 6. BMI\>35 7. Redo or emergency surgery. 8. On preoperative mechanical ventilation and long sedation time. 9. Low EF patients \<35%.