Postoperative Pain and Hemodynamic Profiles in Patients Receiving Preoperative Stellate Ganglion Block for Upper Extremity Surgery: A Case-Control Study

Abstract

Background: Postoperative pain control is clinically important, and the sympathetic nervous system is known to contribute to pain amplification. Stellate ganglion block (SGB) can modulate sympathetic activity and has been widely used for the treatment of chronic pain; however, its role in acute postoperative pain and perioperative hemodynamics remains insufficiently explored. Objectives: This study aimed to evaluate whether preoperative SGB improves postoperative pain outcomes and hemodynamic stability in patients undergoing upper extremity surgery. Methods: A retrospective case-control study was conducted in patients undergoing elective upper extremity surgery under general anesthesia. Patients who received preoperative ultrasound-guided SGB were compared with control patients. The primary outcome was postoperative pain scores on the Numeric Rating Scale (NRS) from 0 to 24 hours. Secondary outcomes included intraoperative and postoperative opioid consumption, time to first analgesic request, perioperative hemodynamic parameters, patient satisfaction, and adverse events. Data were analyzed using SPSS version 23. Results: Thirty-six patients were analyzed (18 SGB and 18 controls). Baseline demographic and surgical characteristics were comparable between groups. Postoperative pain scores were significantly lower in the SGB group at all time points during the first 24 hours (P < 0.05). Intraoperative and postoperative opioid consumption was reduced in the SGB group, and the time to first analgesic request was longer (P < 0.05). Patient satisfaction was higher in the SGB group (P = 0.002). Conclusions: Preoperative SGB was associated with lower postoperative pain scores and reduced opioid requirements; however, no consistent improvement in hemodynamic stability was observed across parameters. These findings suggest that SGB may be a useful adjunct in upper extremity surgery, although prospective studies are needed to confirm its efficacy.