Stellate Ganglion Blockade for Acute Pain Management After Transoral Robotic Surgery
Emily C Wong1, Carlos X Castellanos1, Tristan Grogan2
1UCLA Department of Head and Neck Surgery, Los Angeles, California, USA.
The Laryngoscope
|September 20, 2025
Summary
Stellate ganglion blockade (SGB) effectively reduced postoperative pain and opioid use in transoral robotic surgery (TORS) patients. This pain management technique did not increase hospital stay or complications, showing its safety and efficacy.
Area of Science:
- Otolaryngology
- Pain Management
- Robotic Surgery
Background:
- Pharyngeal pain is a significant challenge after transoral robotic surgery (TORS).
- Stellate ganglion blockade (SGB) is explored as an adjunct for managing postoperative pain.
Purpose of the Study:
- To evaluate the efficacy of SGB in reducing postoperative pain and opioid consumption in TORS patients.
- To assess the impact of SGB on hospital stay and adverse events.
Main Methods:
- Retrospective review of 73 patients undergoing TORS for oropharyngeal carcinoma.
- Comparison between patients who received SGB (bupivacaine injection) and those who did not.
- Analysis of inpatient pain scores, morphine milligram equivalent (MME) usage, OR time, hospitalization length, and complications.
Main Results:
- SGB placement added an average of 13 minutes to operative time.
- Patients receiving SGB showed significantly lower average pain scores (p=0.027).
- SGB group had substantially lower opioid consumption (mean difference 16.37 MME, p<0.001).
Conclusions:
- SGB use led to reduced narcotic pain medication requirements post-TORS.
- SGB did not adversely affect hospitalization duration or complication rates.
- SGB is a safe and effective addition to multimodal pain management after TORS for head and neck cancers.
