Miao Shuai, Tang Shixiao, Xu Jingjing, Song Guodong, Gu Shuhan, Chen Wankun, Zhang Xin, Qian Yiling
Department of Anesthesiology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, China.
Department of Gastrointestinal Surgery, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, China.
J Int Med Res. 2025 Sep;53(9):3000605251378691. doi: 10.1177/03000605251378691. Epub 2025 Sep 25.
ObjectiveTo identify the effect of stellate ganglion block on the incidence of postoperative nausea and vomiting.MethodsWe systematically searched electronic databases for published randomized controlled trials comparing stellate ganglion block with placebo for reducing postoperative nausea and vomiting. The primary outcome was the incidence of postoperative nausea and vomiting after general anesthesia. Meta-regression analysis was performed to investigate potential sources of heterogeneity. Trial sequential analysis was also carried out to calculate the required information size.ResultsIn total, 16 randomized controlled trials including 1385 patients were included in the study. Stellate ganglion block significantly reduced the incidence of postoperative nausea and vomiting (relative risk, 0.59; 95% confidence interval, 0.49-0.70; <0.0001). Our meta-regression analysis confirmed that the significant correlation between stellate ganglion block and reduced postoperative nausea and vomiting risk remained robust and was not significantly influenced by study-level characteristics, including prophylactic antiemetic use, surgical technique, postoperative analgesia, female proportion, age, opioid administration, and inhalation anesthesia. In addition, trial sequential analysis indicated that the Z curve for stellate ganglion block not only crossed the conventional boundary but also the trial sequential analysis boundary for benefit.ConclusionThis meta-analysis suggested an association of stellate ganglion block with a decreased incidence of postoperative nausea and vomiting after general anesthesia. Trial sequential analysis showed that further studies are unlikely to alter the conclusions regarding the incidence of postoperative nausea and vomiting. CRD42024504829.
目的
确定星状神经节阻滞对术后恶心呕吐发生率的影响。
方法
我们系统检索电子数据库，查找比较星状神经节阻滞与安慰剂用于减少术后恶心呕吐的已发表随机对照试验。主要结局是全身麻醉后术后恶心呕吐的发生率。进行Meta回归分析以调查异质性的潜在来源。还进行了试验序贯分析以计算所需的信息量。
结果
本研究共纳入16项随机对照试验，包括1385例患者。星状神经节阻滞显著降低了术后恶心呕吐的发生率（相对风险，0.59；95%置信区间，0.49 - 0.70；<0.0001）。我们的Meta回归分析证实，星状神经节阻滞与降低术后恶心呕吐风险之间的显著相关性仍然很强，且不受研究层面特征的显著影响，这些特征包括预防性使用止吐药、手术技术、术后镇痛、女性比例、年龄、阿片类药物给药和吸入麻醉。此外，试验序贯分析表明，星状神经节阻滞的Z曲线不仅越过了传统界限，还越过了获益的试验序贯分析界限。
结论
这项Meta分析表明星状神经节阻滞与全身麻醉后术后恶心呕吐发生率降低有关。试验序贯分析表明，进一步的研究不太可能改变关于术后恶心呕吐发生率的结论。CRD42024504829
