Stellate ganglion block for attenuating postoperative sore throat after double-lumen tube intubation in thoracic surgery: a randomized clinical study

BACKGROUND: For thoracic surgery patients who undergo double-lumen endotracheal intubation, postoperative sore throat (POST) remains one of the most common postoperative complication. OBJECTIVE: To evaluate whether preoperative ultrasound-guided stellate ganglion block (SGB) can reduce the incidence and severity of POST, and decrease the postoperative throat VAS score in patients undergoing double-lumen tube (DLT) intubation for thoracic surgery. METHODS: This prospective, randomized, double-blind, controlled clinical trial enrolled 120 patients undergoing elective thoracic surgery with DLT intubation. Participants were randomized into two groups: the SGB group (n = 60) received 2-3 ml of 0.25% ropivacaine under ultrasound guidance on the right stellate ganglion, while the control group (n = 60) received no regional anesthetic intervention prior to anesthesia induction. The primary outcomes included the incidence and severity of POST and the visual analogue scale (VAS) scores for throat pain. Secondary outcomes included the incidence of postoperative hoarseness, cough, and postoperative pulmonary complications (PPCs), as well as the levels of serum inflammatory markers before and 1 day after surgery. RESULTS: The incidence of POST was significantly lower in the SGB group at 1 h, 6 h, and 24 h postoperatively compared to the control group (10.3%, 13.8%, and 5.2% vs. 44.1%, 35.6%, and 20.3%, respectively, p < 0.05). The severity grading of POST in the SGB group was also lower than that in the control group at all three time points (p < 0.05). Additionally, the throat VAS scores in the SGB group at 1 h and 6 h postoperatively (0.45 ± 1.45 and 0.34 ± 1.05, respectively) were significantly lower than those in the control group (1.88 ± 2.54 and 0.93 ± 1.41, respectively; p < 0.05). Cough incidence was significantly lower in the SGB group at 1 h and 6 h (both 5.2%) than in the control group (both 20.3%, P = 0.014). CONCLUSIONS: Preoperative ultrasound-guided SGB significantly alleviates POST and reduces the early postoperative cough incidence in thoracic surgery patients undergoing DLT intubation. TRIAL REGISTRATION: The study was registered on Chinese Clinical Trial Registry, (ChiCTR2500106117) on 17/07/2025.