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Esketamine-adjuvanted stellate ganglion block reduces postoperative sleep disturbance after gynecological laparoscopic surgery

Adding an esketamine-adjuvanted stellate ganglion block to intraoperative esketamine and dexmedetomidine significantly reduced the incidence of postoperative sleep disturbance on day 1 (62.9% vs. 83.2%, p=0.002) and day 3 (25.8% vs. 42.1%, p=0.017) in patients undergoing gynecological laparoscopic surgery. The intervention also lowered early postoperative anxiety without increasing perioperative complications.

Last updated: Jul 10, 2026•1 RCTs•📖 Read as article →

Evidence Score

Evidence Score44/100
Human RCT★★☆☆☆
Meta-analysis☆☆☆☆☆
Mechanism★★★★★
Safety★★★★☆
Confidencelow

Study Evidence

Study 1. Esketamine-augmented stellate ganglion block improves postoperative sleep quality after gynecological laparoscopic surgery: a randomized controlled trial.

observational

Wang YL, Zhou L, Xu R, Yang N, Kuang RX, Li LH, Peng LH · BMC anesthesiology (2026)

Participants: N/A
Duration: Postoperative days 1 and 3
Intervention: Esketamine-adjuvanted stellate ganglion block before anesthesia induction plus intraoperative esketamine and dexmedetomidine
Outcome: Incidence of postoperative sleep disturbance on postoperative days 1 and 3; secondary outcomes included postoperative anxiety, depression, pain intensity, rescue medication use, and perioperative complications
Effect Size: N/A (absolute risk reduction of 20.3% on day 1 and 16.3% on day 3)
Population: Patients scheduled for elective gynecological laparoscopic surgery (n=192 in per-protocol analysis)

Result:

PubMed: 42410342DOI: 10.1186/s12871-026-04042-0

Mechanism Graph

Stellate ganglion block modulates sympathetic nervous system activity
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Esketamine provides NMDA receptor antagonism and anti-inflammatory effects
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Combined intervention reduces perioperative stress response
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Result: Lower incidence of postoperative sleep disturbance

Limitations

  • ⚠Single-center study design limits generalizability
  • ⚠No objective sleep assessments (e.g., polysomnography) were used; relied on subjective measures
  • ⚠Findings require confirmation in larger multicenter studies

Frequently Asked Questions

What is postoperative sleep disturbance (PSD)?▼

PSD refers to poor sleep quality or disruption occurring after surgery, which can delay recovery and worsen emotional outcomes.

How does esketamine-adjuvanted stellate ganglion block work?▼

The stellate ganglion block modulates sympathetic nervous activity, while esketamine provides NMDA receptor antagonism and anti-inflammatory effects, together reducing perioperative stress and improving sleep.

Was the intervention safe?▼

No significant differences in adverse events were observed between the intervention and control groups, suggesting the intervention did not increase perioperative complications.

Who might benefit most from this intervention?▼

Subgroup analysis showed a significantly lower incidence of PSD in patients with preoperative depressive symptoms, indicating potential benefit for those with pre-existing mood issues.

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References

  1. 1.Wang YL, Zhou L, Xu R, Yang N, Kuang RX, Li LH, Peng LH. "Esketamine-augmented stellate ganglion block improves postoperative sleep quality after gynecological laparoscopic surgery: a randomized controlled trial.." BMC anesthesiology, 2026. PMID: 42410342 DOI: 10.1186/s12871-026-04042-0
Disclaimer: This content is for educational purposes only and is not medical advice. Evidence scores reflect the quality and quantity of available research, not clinical recommendations. Always consult a healthcare professional before starting any supplement or intervention.