Efficacy of ultrasound-guided stellate ganglion block on relieving acute postoperative pain: systematic review and meta-analysis

Background The efficacy of stellate ganglion block (SGB) in alleviating postoperative pain remains uncertain. This meta-analysis aimed to determine the efficacy of ultrasound-guided SGB in relieving acute postoperative pain in patients undergoing surgery with general anesthesia. Methods A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted comparing SGB with control or placebo. The primary outcome was pain score at 24h after surgery. Secondly outcomes included postoperative pain scores at other times (0, 2, 4, 6, 8, 12h) and postoperative nausea and vomiting. A random effects model was used to calculate mean difference (MD) or risk ratio (RR) with 95% confidence intervals. Results Eight studies, with a total of 470 patients, were included in this meta-analysis. Ultrasound-guided SGB was associated with lower pain score at 24h after surgery (MD − 0.71; 95% CI: −1.26, − 0.16, p = 0.01, I2 = 86%), with low level of evidence. Ultrasound-guided SGB was also linked to a lower pain score at postoperative 8h (MD − 0.65; 95% CI: −1.03, − 0.28, p = 0.01, I2 = 29%), with moderate level of evidence. There was no difference in pain scores at 0, 2, 4, 6,12 hours after surgery. Conclusion Ultrasound-guided SGB is effective in alleviating acute postoperative pain. However, given the low level of evidence and a limited number of trials, more large-scale and high-quality RCTs are required in the future researches.