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Introduction <p>Postoperative nausea and vomiting (PONV) is one of the most common postoperative complications, with particularly high rates in patients undergoing high-risk surgeries such as gynecologic laparoscopy. Although there are many pharmacological and non-pharmacological methods that can prevent PONV, the incidence remains high. This study assessed the effectiveness of a right stellate ganglion block (SGB) in preventing PONV in gynecological laparoscopy patients, while also exploring the potential mechanisms involved.</p> Methods <p>Two hundred patients were randomly assigned to either a right SGB under ultrasound guidance 30&#xa0;min before anesthesia (SGB group) or no treatment (control group). The primary outcome was PONV incidence within 24&#xa0;h post surgery. Secondary outcomes included nausea and vomiting severity, pain scores, postoperative flatus time, sleep quality, and satisfaction scores.</p> Results <p>The incidence of PONV in the SGB group was 38%, significantly lower than the 60% in the control group (<i>P</i> = 0.002). Severity of PONV was also notably reduced in the SGB group (<i>P</i> = 0.004). Resting pain scores in the SGB group at 6&#xa0;h (0.0 [0.0, 1.0] vs. 0.0 [0.0, 2.0], <i>P</i> = 0.013), 12&#xa0;h (0.0 [0.0, 1.0] vs. 0.0 [0.0, 2.0], <i>P</i> = 0.027), and 24&#xa0;h (0.0 [0.0, 1.0] vs. 0.0 [0.0, 2.0], <i>P</i> = 0.011) were lower than in the control group. Post-activity pain scores at 6&#xa0;h (2.0 [1.0, 3.0] vs. 3.0 [1.25, 4.0], <i>P</i> = 0.000), 12&#xa0;h (2.0 [1.0, 3.0] vs. 3.0 [1.25, 4.0], <i>P</i> = 0.002), and 24&#xa0;h (2.0 [1.0, 3.0] vs. 3.0 [2.0, 4.0], <i>P</i> = 0.001) were also lower. The time to first postoperative flatus was shorter in the SGB group (<i>P</i> = 0.033). Overall postoperative satisfaction (<i>P</i> = 0.002) and analgesia satisfaction (<i>P</i> = 0.002) were higher, and sleep quality was improved (<i>P</i> = 0.046).</p> Conclusion <p>A right stellate ganglion block reduces PONV, pain, and postoperative flatus time, and improves sleep quality and satisfaction in gynecological laparoscopy patients, proving it to be a safe and effective method.</p> <p><b>Trial Registration</b>: NCT06426186.</p>

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Effect of Right Stellate Ganglion Block on Preventing Postoperative Nausea and Vomiting in Gynecological Laparoscopic Patients: A Randomized Controlled Trial

  • 期刊论文

  • 发表日期：

    2025年2月10日

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  • Yu Liu,
  • Guangxi Piao,
  • Jie Chen,
  • Guangyou Duan,
  • Ling Dan,
  • Guizhen Chen,
  • Yamei Zhang

摘要

Introduction

Postoperative nausea and vomiting (PONV) is one of the most common postoperative complications, with particularly high rates in patients undergoing high-risk surgeries such as gynecologic laparoscopy. Although there are many pharmacological and non-pharmacological methods that can prevent PONV, the incidence remains high. This study assessed the effectiveness of a right stellate ganglion block (SGB) in preventing PONV in gynecological laparoscopy patients, while also exploring the potential mechanisms involved.

Methods

Two hundred patients were randomly assigned to either a right SGB under ultrasound guidance 30 min before anesthesia (SGB group) or no treatment (control group). The primary outcome was PONV incidence within 24 h post surgery. Secondary outcomes included nausea and vomiting severity, pain scores, postoperative flatus time, sleep quality, and satisfaction scores.

Results

The incidence of PONV in the SGB group was 38%, significantly lower than the 60% in the control group (P = 0.002). Severity of PONV was also notably reduced in the SGB group (P = 0.004). Resting pain scores in the SGB group at 6 h (0.0 [0.0, 1.0] vs. 0.0 [0.0, 2.0], P = 0.013), 12 h (0.0 [0.0, 1.0] vs. 0.0 [0.0, 2.0], P = 0.027), and 24 h (0.0 [0.0, 1.0] vs. 0.0 [0.0, 2.0], P = 0.011) were lower than in the control group. Post-activity pain scores at 6 h (2.0 [1.0, 3.0] vs. 3.0 [1.25, 4.0], P = 0.000), 12 h (2.0 [1.0, 3.0] vs. 3.0 [1.25, 4.0], P = 0.002), and 24 h (2.0 [1.0, 3.0] vs. 3.0 [2.0, 4.0], P = 0.001) were also lower. The time to first postoperative flatus was shorter in the SGB group (P = 0.033). Overall postoperative satisfaction (P = 0.002) and analgesia satisfaction (P = 0.002) were higher, and sleep quality was improved (P = 0.046).

Conclusion

A right stellate ganglion block reduces PONV, pain, and postoperative flatus time, and improves sleep quality and satisfaction in gynecological laparoscopy patients, proving it to be a safe and effective method.

Trial Registration: NCT06426186.