Stellate ganglion block for preventing perioperative arrhythmias: a systematic review and meta-analysis.

BACKGROUND

Perioperative arrhythmias are frequent complications among surgical patients, associated with increased morbidity and mortality rates. Stellate ganglion block (SGB) has been proposed as an alternative intervention to reduce arrhythmogenic risk, but its effectiveness has not been systematically quantified. The aim of this meta-analysis is to evaluate the effect of SGB on the incidence of perioperative arrhythmias in adult surgical patients.

METHODS

We searched Ovid MEDLINE, Ovid Embase, Cochrane CENTRAL, and Scopus from 1970 to 2025. Included studies were randomised controlled trials and observational studies comparing SGB with placebo, no intervention, or alternative therapies in adult surgical patients under general anaesthesia. Two reviewers independently screened titles and abstracts and completed full-text review, data collection, and risk of bias assessment of eligible studies. Odds ratios with a 95% confidence interval were utilised as measure of association. Certainty of evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. The primary outcome was the incidence of perioperative arrhythmias, defined as intraoperative or postoperative atrial or ventricular arrhythmias, measured via continued electrocardiographic monitoring.

RESULTS

Seven studies including 547 patients were included. SGB was associated with a significantly lower odds of perioperative arrhythmias compared with controls (odds ratio 0.22, 95% confidence interval 0.14-0.35). Findings were consistent across surgical types and arrhythmia subtypes. No serious adverse events related to SGB were reported.

CONCLUSIONS

Stellate ganglion block appears to reduce the incidence of perioperative arrhythmias in surgical patients. These findings support the therapeutic potential of stellate ganglion block, though further high-quality trials are warranted to validate efficacy and guide clinical adoption.