What question did this study set out to answer?

This research aims to assess the effects of stellate ganglion block (SGB) on swallowing function and anxiety in patients with bulbar palsy after ischemic stroke.

March 6, 2026BMC Medicine0 citationsOpen Access

Effects of ultrasound-guided stellate ganglion block in poststroke bulbar palsy: a double-blind placebo-controlled trial

HZHongji ZengChinese Academy of Medical Sciences & Peking Union Medical College YFYong FanUniversity of Pennsylvania YYYing YangThe Fifth People’s Hospital of Suzhou

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This research aims to assess the effects of stellate ganglion block (SGB) on swallowing function and anxiety in patients with bulbar palsy after ischemic stroke.
Randomized, double-blind, placebo-controlled trial
Included 124 participants undergoing rehabilitation
Participants randomized to SGB or placebo for 10 days
Primary outcome measured was dysphagia severity
Secondary outcomes included hyoid bone movement distances, airway protection, and anxiety levels.
Significant improvements in dysphagia severity, hyoid bone movement, and anxiety (P < 0.001) after SGB
Temporary increase in vertebral artery blood flow and internal diameter after SGB
Long-term benefits observed in swallowing function and airway protection post-treatment.

Resumen

Bulbar palsy typically causes severe dysphagia. Based on rehabilitation interventions, stellate ganglion block (SGB) might improve swallowing function by regulating sympathoexcitation and cerebral perfusion. This study explored the short- and long-term effects of SGB on swallowing function, anxiety, and cerebral blood flow in patients with bulbar palsy after ischemic stroke. This randomized double-blind placebo-controlled trial included 124 participants in rehabilitation departments from March 2024 to July 2025 in China. The participants were randomized 1:1 to SGB or placebo groups, and all received routine treatment for 10 consecutive days. The SGB group received SGB with lidocaine hydrochloride, whereas the placebo group received block with normal saline. The primary outcome was the clinical severity of dysphagia. The secondary outcomes were airway protection, forward and upward movement distances of the hyoid bone, accumulation of secretions, pharyngeal residue, anxiety, and mean blood flow velocity (Vm) and internal diameter of the vertebral artery. The Vm and internal diameter were additionally assessed one hour after the first SGB. Repeated measures ANOVA and generalized estimating equations were used to explore time, group, and their interaction effects. There were no significant baseline inter-group differences. After treatment, significant (P 0.06), movement distances of the hyoid bone (η2 > 0.19), airway protection (β = − 0.774), pharyngeal residue (β < − 0.54), accumulation of secretions (β = − 0.371), and anxiety (η2 = 0.462). These effects remained significant at follow-up. After the first SGB, the Vm and internal diameter of the vertebral artery on the SGB side significantly increased (P < 0.001) in the SGB group, but the inter-group differences were non-significant after the intervention period. In patients with bulbar palsy after ischemic stroke who receive routine treatment, SGB is safe and can effectively improve swallowing function, airway protection, and anxiety. The effects of SGB on vertebral artery blood flow are temporary, but the functional impacts are long-term. ClinicalTrials.gov. (Unique identifier: NCT06319534, 20/03/2024).

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