Abstract
BackgroundThe return of gastrointestinal function is an important sign of postoperative recovery in patients undergoing surgery with general anaesthesia. We aimed to summarize the effects of stellate ganglion block on the recovery of gastrointestinal function as a means of exploring methods through which anaesthesiologists can contribute to postoperative patient recovery.MethodsWe performed a quantitative systematic review of randomized controlled trials published between January 1, 1988, and November 11, 2019, in PubMed, the Cochrane Library, China National Knowledge Infrastructure, Chinese VIP Information, and the Wanfang and SinoMed databases. Study quality was assessed by using the GRADE criteria and bias of included studies were assessed using the revised Cochrane risk-of-bias tool for randomized trials. The time to peristaltic sound resumption, flatus, postoperative eating and the incidence of abdominal bloating in the stellate ganglion block and control groups were compared. The control group consisted of either a stellate ganglion block with normal saline or no treatment. Meta-analysis was performed using Review Manager software.ResultsAfter searching for relevant articles, 281 studies were identified, and five articles with data on 274 patients were eligible. Regarding postoperative flatus time, stellate ganglion block resulted in a mean reduction of 15 h (P = 0.02); then a sensitivity analysis was performed, and the standard mean difference decreased to 6 h (P = 0.007). For gastrointestinal surgery, the mean reduction was 23.92 h (P = 0.0002). As for the evaluation of the recovery of peristaltic sounds, stellate ganglion block promoted the recovery of regular peristaltic bowel sounds an average of 14.67 h earlier than in the control (P = 0.0008). When it comes to nutrients, stellate ganglion block shortened the total parenteral nutrition time by more than 50 h in patients who had undergone gastrointestinal surgery (P<0.00001). Finally, stellate ganglion block prevented the occurrence of postoperative abdominal bloating (P = 0.001).) No complications related to stellate ganglion block were reported.ConclusionStellate ganglion block may promote postoperative gastrointestinal recovery in patients undergoing various surgeries under general anaesthesia. However, additional trials investigating the use of stellate ganglion block are necessary to confirm our finding.Trial registrationThis meta-analysis has been registered at the International Prospective Register of Systematic Reviews (registration number CRD42020157602).
Highlights
The return of gastrointestinal function is an important sign of postoperative recovery in patients undergoing surgery with general anaesthesia
Of the 276 excluded studies, 41 were removed for duplications, 215 were removed after screening of their titles and abstracts according to the inclusion criteria, 1 was removed because the patient did not receive general anaesthesia, 5 were removed because they were not human studies, 12 were removed because they were not postoperative studies, 1 was removed because it did not focus on GI function, and 1 was removed because it was published repeatedly
Our analysis suggests that Stellate ganglion block (SGB) may shorten the postoperative flatus time in patients who undergo various types of surgery under general anaesthesia, with a mean reduction of more than 6 h
Summary
The return of gastrointestinal function is an important sign of postoperative recovery in patients undergoing surgery with general anaesthesia. The return of gastrointestinal (GI) function is an important sign of postoperative recovery in patients who have undergone surgery under general anaesthesia, especially in patients who receive abdominal surgery. Delayed recovery and postoperative disturbances of GI function prevent patients from resuming a normal diet and may lead to complications such as postoperative nausea and vomiting, abdominal distension and intestinal obstruction. It can increase the incidence of anxiety and insomnia. Opioid usage can exacerbate GI dysfunction and delay GI recovery by acting peripherally [3]
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