Effects of ultrasound-guided stellate ganglion block on intrapulmonary shunt and oxygenation in patients with single-lung ventilation.

Summary

In a double-blind randomized trial (registered ChiCTR2200063210), ultrasound-guided stellate ganglion block during thoracoscopic lobectomy improved oxygenation-related physiology by reducing intrapulmonary shunt and enhancing respiratory mechanics and hemodynamics. Anti-inflammatory effects were also observed, supporting a protective role during single-lung ventilation.

Key Findings

• SGB improved respiratory mechanics and hemodynamics during SLV compared with control.
• SGB reduced intrapulmonary shunt and enhanced oxygenation parameters.
• Inflammatory responses were attenuated with SGB, suggesting organ-protective effects.

Clinical Implications

Consider ultrasound-guided stellate ganglion block as an adjunct for patients at risk of hypoxemia during single-lung ventilation in thoracic surgery, with appropriate team training and monitoring.

Limitations

• Single-center study with modest sample size (n=88 analyzed).
• Limited reporting on long-term clinical outcomes beyond perioperative physiology.

Future Directions

Multicenter trials should validate efficacy, define optimal timing/dosing, and assess impacts on hypoxemia episodes, ICU admission, and recovery metrics.