A meta-analysis of ultrasound-guided stellate ganglion block on the quality of recovery after cancer surgery.

Abstract

Pain is a prevalent symptom among patients with cancer, significantly impacting their health and quality of life. Stellate ganglion block (SGB) has been employed as a diagnostic, prognostic, or therapeutic intervention for various pain syndromes. This systematic review and meta-analysis aimed to examine the effects of ultrasound-guided SGB on postoperative recovery quality and other functional indicators following cancer surgery. Data were sourced from PubMed, PEDro, CINAHL, SportDiscus, and Scopus. Inclusion criteria followed the population-intervention-comparison-outcome principle. The evaluation process involved meticulous screening, judicious data extraction, and rigorous assessment of trial methodology quality, conducted independently by 2 researchers. Standardized mean differences with corresponding 95% confidence intervals were pooled using either a random-effects or fixed-effects model. Ultrasound-guided SGB exhibited potential for improving postoperative pain scores after cancer surgery (RR, 7.81 [95% confidence interval (CI), 5.43-10.19]), reducing daily consumption of oxycodone (RR, 0.78 [95% CI, -1.37 to 2.93]) and pregabalin (RR, -22.26 [95% CI, -91.37 to 46.85]), enhancing physical health (RR, -2.50 [95% CI, -11.00 to 6.00]) and mental health (RR, -5.10 [95% CI, -13.45 to 3.25]), and influencing mean arterial pressure (RR, -10.60 [95% CI, -17.92 to -3.27]), mean pulmonary artery pressure (RR, -1.02 [95% CI, -2.83 to 0.79]), heart rate (RR, -11.18 [95% CI, -17.91 to -4.46]), and central venous pressure (RR, -0.05 [95% CI, -1.53 to 1.43]) as effective treatment modalities. This systematic review and meta-analysis suggests that ultrasound-guided SGB therapy is effective in reducing pain levels and improving mobility and quality of life compared to conventional treatments. Therefore, clinicians should consider administering SGBs to patients with chronic cancer pain, emphasizing sensory exercise to achieve a balance between movement and rest.