Despite advancements in laparoscopic techniques, postoperative pain and nausea/vomiting (PONV) remain primary barriers to optimal Enhanced Recovery After Surgery (ERAS) outcomes in gynecology. While stellate ganglion block (SGB) modulates autonomic function, its efficacy in elevating pain thresholds, reducing rescue medication use, and accelerating functional recovery requires robust evidence. This randomized trial evaluated whether preoperative SGB could refine these ERAS metrics. This single-center randomized controlled trial included 84 patients undergoing elective gynecological laparoscopy, who were randomly allocated via computer-generated sequence to receive ultrasound-guided right-sided SGB (5 mL 0.25% ropivacaine at C6) or standard care. Primary endpoints were mechanical pain thresholds (von Frey filaments) and 48-h cumulative PONV incidence; secondary outcomes included VAS pain scores, rescue analgesic/antiemetic requirements, gastrointestinal recovery (time to first flatus/oral intake), and hospital stay. The SGB group exhibited significantly higher mechanical pain thresholds at 24 h (P 0.05). Transient Horner’s syndrome occurred in all SGB patients, with no severe complications reported. Preoperative SGB serves as a potent adjunct in gynecological ERAS protocols. By simultaneously elevating pain tolerance and curbing PONV, it facilitates a smoother and faster early recovery phase. Chinese Clinical Trial Registry, ChiCTR2300068430. Registered 18 February 2023, http://www.chictr.org.cn/showproj.aspx?proj=189182.
Lu et al. (Wed,) studied this question.