Clinical Report: Impact of Preoperative Stellate Ganglion Block on POD

Overview

This study protocol outlines a randomized controlled trial to evaluate the efficacy of preoperative stellate ganglion block (SGB) in reducing postoperative delirium (POD) in elderly patients undergoing gastrointestinal cancer surgery. The trial aims to provide evidence on the feasibility and effectiveness of SGB as a targeted intervention for this high-risk population.

Background

Postoperative delirium (POD) is a significant complication in elderly patients, occurring in 35% to 48% of those undergoing gastrointestinal surgery, leading to increased morbidity and healthcare costs. Current prevention strategies are limited, necessitating novel interventions like the stellate ganglion block (SGB), which may address underlying pathophysiological mechanisms associated with POD.

Data Highlights

This study will enroll 174 elderly patients, comparing the effects of SGB versus a sham block on POD incidence and severity, among other outcomes.

Key Findings

• Postoperative delirium occurs in 35% to 48% of elderly patients undergoing gastrointestinal surgery.
• Current non-pharmacologic interventions are insufficient to fully mitigate POD risk.
• Stellate ganglion block may modulate neuro-inflammation and improve cerebral blood flow.
• This study aims to fill the gap in high-quality randomized controlled trials evaluating SGB for POD prevention.
• The primary outcome is the cumulative incidence of POD within postoperative days 1-3.

Clinical Implications

The findings from this trial may inform future clinical practices regarding the use of SGB in preventing POD in high-risk elderly surgical patients. Understanding the efficacy of SGB could lead to improved postoperative outcomes and reduced healthcare costs.

Conclusion

This study seeks to provide preliminary evidence on the effectiveness of preoperative SGB in reducing POD in elderly patients undergoing gastrointestinal cancer surgery. The results may contribute to the development of targeted interventions for this vulnerable population.

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