Effect of Stellate Ganglion Block in Relieving Postoperative Pain After Surgery: A Systematic Review and Meta-Analysis

Shuangshuang Xu, Zhongjie Zhang, Tong Wu, Qihong Shen Department of Anesthesiology, Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang, People’s Republic of ChinaCorrespondence: Qihong Shen, Department of Anesthesiology, Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang, People’s Republic of China, Email shenqihong1989@163.comObjective: Postoperative acute pain is a common complication after surgery. Stellate ganglion block (SGB) has been reported to relieve pain, but evidence remains inconsistent. A prior meta-analysis had limitations, including unexplained heterogeneity and incomplete data. Therefore, we conducted this updated meta-analysis to evaluate the effectiveness of SGB in reducing postoperative pain in patients undergoing surgery under general anesthesia.Methods: We searched PubMed, EMBASE, Cochrane Library and Web of Science for randomized controlled trials (RCTs) comparing stellate ganglion block (SGB) with control (placebo or no treatment) in adults undergoing surgery under general anesthesia. According to the PICO framework: Population-adults under general anesthesia; Intervention-preoperative SGB; Comparison-control (placebo or no treatment); Outcome-postoperative pain scores. The GRADE methodology was utilized to appraise evidence quality. Mean differences (MD) or risk ratios (RR) were calculated using random-effects models.Results: Eight RCTs involving 562 patients were included. SGB reduced postoperative pain score at 6 hours (MD = − 0.62; 95% CI: − 0.92, − 0.32, I2 = 72%). Crucially, subgroup analysis based on anatomical innervation zones (direct vs. indirect) successfully resolved heterogeneity (I2 = 0 in both subgroups). SGB also reduced pain score at 12 hours (MD = − 0.24; 95% CI: − 0.47, − 0.02, I2 = 55%), whereas a slight reduction was observed at 24 hours (MD = − 0.48; 95% CI: − 0.96, − 0.01). Furthermore, SGB decreased the incidence of postoperative nausea and vomiting, and arrhythmias.Conclusion: Current evidence suggests that SGB may reduce early postoperative pain; however, the certainty of this evidence is very low.