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Stellate ganglion block shows favorable trends in perioperative psychological symptoms and postoperative recovery quality in non-elderly patients undergoing total hip arthroplasty for osteonecrosis of the femoral head, but evidence is inconsistent and not robust to baseline adjustment.

In a randomized controlled trial of 94 non-elderly patients undergoing total hip arthroplasty for osteonecrosis of the femoral head, those receiving ultrasound-guided stellate ganglion block with 4 mL of 0.8% lidocaine showed improved GAD-7 scores and higher QoR-15 scores compared to placebo. However, the GAD-7 effect was not confirmed after adjusting for baseline scores, and HADS depression/anxiety scores did not reach statistical significance.

Last updated: Jul 22, 2026•1 RCTs•📖 Read as article →

Evidence Score

Evidence Score48/100
Human RCT★★☆☆☆
Meta-analysis☆☆☆☆☆
Mechanism★★★★★
Safety★★★★☆
Confidencelow

Study Evidence

Study 1. Effect of stellate ganglion block on perioperative psychological symptoms and recovery after total hip arthroplasty for osteonecrosis of the femoral head in non-elderly patients: a randomized controlled trial.

observational

Fan X, Huang Z, Li X, Li J, Lin B, Zhang X · BMC anesthesiology (2026)

Participants: N/A
Duration: 4 days (postoperative days 1 and 4)
Intervention: Ultrasound-guided unilateral stellate ganglion block with 4 mL of 0.8% lidocaine before surgery
Outcome: Perioperative psychological symptoms (anxiety via GAD-7 and HADS, depression via HADS), postoperative recovery quality (QoR-15), pain intensity (VAS), sleep quality, and adverse events
Effect Size: N/A (primary mixed-effects analysis P < 0.05 for GAD-7 and QoR-15, but ANCOVA adjusting for baseline GAD-7 not significant)
Population: Non-elderly patients undergoing total hip arthroplasty for osteonecrosis of the femoral head

Result:

PubMed: 42464128DOI: 10.1186/s12871-026-04097-z

Mechanism Graph

Stellate ganglion block inhibits sympathetic outflow to the head, neck, and upper limb
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Reduced sympathetic activity may lower stress hormone release and modulate pain pathways
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Decreased perioperative stress may improve psychological symptoms such as anxiety
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Result: Favorable trends in anxiety scores and recovery quality, but inconsistent across scales

Limitations

  • ⚠GAD-7 effect was not robust to baseline adjustment, indicating potential confounding or insufficient power
  • ⚠HADS scores did not reach statistical significance, suggesting inconsistent psychological effects across measurement tools
  • ⚠Single-center design and relatively small sample size may limit generalizability

Frequently Asked Questions

What is stellate ganglion block?▼

Stellate ganglion block is a procedure where a local anesthetic is injected near the stellate ganglion in the neck to temporarily block sympathetic nerve activity, often used for pain management and certain autonomic conditions.

Did stellate ganglion block significantly reduce anxiety in this study?▼

The study found favorable trends in GAD-7 scores with SGB, but the effect was not statistically significant after adjusting for baseline anxiety scores, so the evidence is inconclusive.

What were the main outcomes measured?▼

The study measured anxiety (GAD-7, HADS), depression (HADS), pain intensity (VAS), sleep quality, postoperative recovery quality (QoR-15), and adverse events.

Is stellate ganglion block safe for this patient population?▼

The study reported no significant difference in adverse events (hypotension, dizziness, nausea/vomiting, nightmares) between the SGB and control groups, suggesting it was well-tolerated.

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References

  1. 1.Fan X, Huang Z, Li X, Li J, Lin B, Zhang X. "Effect of stellate ganglion block on perioperative psychological symptoms and recovery after total hip arthroplasty for osteonecrosis of the femoral head in non-elderly patients: a randomized controlled trial.." BMC anesthesiology, 2026. PMID: 42464128 DOI: 10.1186/s12871-026-04097-z
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.