Efficacy and safety of stellate ganglion block for postoperative pain management: a systematic review and meta-analysis of randomized controlled trials

BACKGROUND: Stellate ganglion block (SGB) is a form of regional anesthesia employed to reduce postoperative pain management. This meta-analysis assesses its efficacy and safety for postoperative pain control. METHODS: We conducted a comprehensive search of PubMed, Embase, Cochrane Library, and Web of Science covering all records up to September 20,2025 to identify eligible randomized controlled trials (RCTs). Stata 15.0 software was applied for data analysis, and RevMan 5.4 was employed to assess the risk of bias. RESULTS: A total 33 RCTs comprising 2231 participants were included, SGB may reduce pain at 6[SMD=-1.35, 95%CI(-1.96, -0.73)], 12[SMD=-1.09, 95%CI(-1.83, -0.35)]and 24[SMD=-1.03, 95%CI(-1.56, -0.20)] hours postoperatively, whereas no significant difference was observed at 48 h and postoperative total opioid consumption [SMD = - 0.55, 95% CI (- 1.24, 0.13)] and and ICU stays [MD=-0.37, 95% CI(- 0.95, 0.21)]. It shortened hospital stay [MD = - 1.04, 95% CI (- 1.74, - 0.34)], reduced the incidence of postoperative nausea and vomiting[RR = 0.55, 95% CI (0.40, 0.77)], but the incidence of upper eyelid ptosis was markedly higher than in the control group [RR = 31.67, 95% CI (6.43, 155.90)]. CONCLUSIONS: Stellate ganglion block may help alleviate early pain (6, 12, and 24 h) postoperatively, It also shortens hospital and the ICU stays and reduces the incidence of nausea and vomiting but increases the incidence of upper eyelid ptosis. Analysis showed no significant group-to-group differences in other indicators. Given the limitations of the included studies, further high-quality, large-sample randomized controlled trials are needed to confirm and expand upon the efficacy and safety of stellate ganglion block.