Department of Anesthesiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China.
Medicine (Baltimore). 2024 Sep 27;103(39):e39559. doi: 10.1097/MD.0000000000039559.
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.
疼痛是癌症患者常见的症状，严重影响其健康和生活质量。星状神经节阻滞（SGB）已被用于各种疼痛综合征的诊断、预后或治疗干预。本系统评价和荟萃分析旨在研究超声引导 SGB 对癌症手术后恢复质量和其他功能指标的影响。
数据来源于 PubMed、PEDro、CINAHL、SportDiscus 和 Scopus。纳入标准遵循人群-干预-比较-结局原则。评估过程涉及仔细筛选、明智的数据提取和严格的试验方法质量评估，由 2 名研究人员独立进行。使用随机效应或固定效应模型，汇总标准化均数差及其相应的 95%置信区间。
超声引导 SGB 可能改善癌症手术后的术后疼痛评分（RR，7.81 [95%置信区间（CI），5.43-10.19]），减少术后阿片类药物（RR，0.78 [95% CI，-1.37 至 2.93]）和普瑞巴林（RR，-22.26 [95% CI，-91.37 至 46.85]）的每日消耗量，提高身体健康（RR，-2.50 [95% CI，-11.00 至 6.00]）和心理健康（RR，-5.10 [95% CI，-13.45 至 3.25]），并影响平均动脉压（RR，-10.60 [95% CI，-17.92 至 -3.27]）、平均肺动脉压（RR，-1.02 [95% CI，-2.83 至 0.79]）、心率（RR，-11.18 [95% CI，-17.91 至 -4.46]）和中心静脉压（RR，-0.05 [95% CI，-1.53 至 1.43]），作为有效的治疗方式。
本系统评价和荟萃分析表明，与传统治疗相比，超声引导 SGB 治疗可有效降低疼痛水平，提高活动能力和生活质量。因此，临床医生应考虑为患有慢性癌症疼痛的患者实施 SGB，并强调感觉运动，以实现运动与休息之间的平衡。
