Preoperative Ultrasound-Guided Stellate Ganglion Block for Prevention of Postoperative Sore Throat After Thoracic...

Postoperative sore throat (POST) is one of the most common complaints after thoracic surgery with double-lumen endobronchial tubes (DLTs), significantly impacting postoperative recovery and patient satisfaction, yet it is often overlooked. Stellate ganglion block (SGB), a minimally invasive technique, may alleviate airway inflammation and modulate sympathetic tone. It has significant potential in reducing the incidence of POST, but evidence in DLTs patients is lacking. This trial aims to test whether preoperative ultrasound-guided SGB can ameliorate the incidence and severity of POST after thoracic surgery.

In this prospective double-blind, randomized controlled trial, 132 patients undergoing thoracoscopic resection of pulmonary lobes/segments with DLTs will be randomized to receive either US-guided SGB with 0.25% ropivacaine 4mL (Group S) or 0.9% saline 4mL (Group C) at the C6 level, on the same side as the thoracic surgery before anesthesia induction. The primary outcome is POST incidence at 6 hours postoperatively. The secondary outcomes include the incidence and severity of POST at 1, 24 and 48 hours, postoperative pain score (NRS) at different time points, postoperative nausea and vomiting, hoarseness, Quality of Recovery-15 scores, RCSQ sleep score, PCIA dosage at 24 and 48 hours. Intraoperative hemodynamic fluctuations, regional cerebral oxygen saturation (rSO₂), anesthetic and vasoactive drugs will be recorded. All statistical analyses will be performed using SPSS version 26.0. Two-sided P values <0.05 will be considered statistically significant.

This is the first prospective trial evaluating ultrasound-guided SGB for POST after thoracic surgery with DLTs, also assessing the effect of SGB on postoperative recovery quality. The findings will provide more clinical evidence for perioperative SGB application to enhance early postoperative recovery and patient satisfaction.