Ultrasound-guided Stellate Ganglion Block Improves Gastrointestinal Function After Thoracolumbar Spinal Surgery.

PURPOSE: The purpose of this study was to investigate the effects of stellate ganglion block (SGB) on gastrointestinal function after thoracolumbar spinal surgery.

METHODS

Forty patients with thoracolumbar fracture scheduled for posterior spinal surgery were randomly assigned to 2 groups: ultrasound-guided SGB or sham (control group). After induction, ultrasound-guided SGB (n = 20) or a sham procedure (n = 20) was conducted with a 6-mL injection of 1% lidocaine or 0.9% saline, respectively. Primary outcomes were postoperative gastrointestinal function, including auscultation of bowel sounds, incidence and degree of abdominal bloating, flatus time, and paralytic ileus.

FINDINGS: Patients in the SGB group had better gastrointestinal function compared with those in the sham (control) group, as indicated by more regular bowel sounds at 24 and 36 hours postoperatively (80% vs 40%, P = 0.024, and 95% vs 60%, P = 0.023), lesser abdominal bloating (10% vs 45%, P = 0.034), and slightly shorter flatus time (mean [SD], 12.0 [4.4] vs 14.7 [4.6] hours, P = 0.068). Survival analysis based on regular bowel sounds found a significant difference between the 2 groups (P = 0.004). In addition, more patients had higher satisfaction after SGB (85% vs 45%, P = 0.020). No postoperative ileus or mortality occurred.

IMPLICATIONS: In this preliminary study, ultrasound-guided SGB accelerated the return of gastrointestinal transit, alleviated bowel symptoms, and improved patient satisfaction after thoracolumbar spinal surgery. chictr.org.cn identifier: ChiCTR-TRC-14004289.