Clinical mechanisms of continuous stellate ganglion block in improving postoperative anxiety and depression after thoracoscopic lung cancer surgery

doi:10.5498/wjp.116727

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World Journal of Psychiatry

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2220-3206

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Psychiatry. Jul 19, 2026; 16(7): 116727
Published online Jul 19, 2026. doi: 10.5498/wjp.116727

Clinical mechanisms of continuous stellate ganglion block in improving postoperative anxiety and depression after thoracoscopic lung cancer surgery

Ye-Ming Wang, Lu Zhang, Xiao-Jia Sun, Wei Jing, Xuan Liu

Xuan Liu, Xiao-Jia Sun, Ye-Ming Wang, Department of Anesthesiology, The First Affiliated Hospital of Hebei North University, Zhangjiakou 075000, Hebei Province, China

Wei Jing, Lu Zhang, Operating Room, The First Affiliated Hospital of Hebei North University, Zhangjiakou 075000, Hebei Province, China

Author contributions: Liu X, Sun XJ, and Zhang L collected the data; Liu X and Sun XJ contributed to clinical investigation; Liu X and Jing W analyzed the data; Liu X designed the study and drafted the manuscript; Jing W and Wang YM revised the manuscript; Wang YM supervised the study and obtained funding; All authors approved the final manuscript and take responsibility for the integrity of the work.

Supported by the 2026 Hebei Provincial Medical Science Research Program, No. 20260801.

Institutional review board statement: This study was approved by the Medical Ethics Committee of the First Affiliated Hospital of Hebei North University, approval No. K2025129.

Informed consent statement: The requirement for informed consent was waived due to the retrospective nature of the study and the use of anonymized clinical data.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

Data sharing statement: The data supporting the findings of this study are available from the corresponding author upon reasonable request.

Corresponding author: Ye-Ming Wang, Associate Chief Physician, Department of Anesthesiology, The First Affiliated Hospital of Hebei North University, No. 12 Changqing Road, Zhangjiakou 075000, Hebei Province, China. hbbfxyfsdyyywym@163.com

Received: November 28, 2025
Revised: December 27, 2025
Accepted: April 2, 2026
Published online: July 19, 2026
Processing time: 210 Days and 2.6 Hours

Abstract

BACKGROUND

To investigate the effects of continuous stellate ganglion block (CSGB) on anxiety and depression in patients after thoracoscopic lung cancer surgery, and to analyze its potential clinical mechanisms and relationship with postoperative pain, sleep quality, and recovery progress.

AIM

To assess the effect of CSGB on postoperative anxiety and depression after thoracoscopic lung cancer surgery.

METHODS

A retrospective analysis included 135 patients who underwent thoracoscopic lung cancer resection at a tertiary hospital from January 2021 to December 2023. The CSGB group (n = 65) received CSGB treatment postoperatively, while the control group (n = 70) did not receive CSGB intervention. Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) scores were collected preoperatively and on postoperative days 1, 3, and 7. Visual Analog Scale (VAS) for pain, Pittsburgh Sleep Quality Index, time to first ambulation, chest tube removal time, postoperative hospital stay, and complications were recorded. Logistic regression analyzed independent risk factors for anxiety and depression, and Pearson correlation assessed the relationship between pain and emotional states.

RESULTS

SAS and SDS scores on postoperative days 3 and days 7 were significantly lower in the CSGB group compared to controls (P < 0.01). VAS scores were also markedly reduced, Pittsburgh Sleep Quality Index scores improved, and time to first ambulation, chest tube removal time, and hospital stay were significantly shortened (P < 0.05). Logistic regression showed that poor postoperative pain control was an independent risk factor for anxiety and depression (odds ratio = 2.34, P < 0.05). Pearson analysis revealed positive correlations between VAS scores and SAS/SDS scores (r = 0.62, P < 0.01). The CSGB group also had lower incidence of complications such as nausea, vomiting, and arrhythmias compared to controls (P < 0.05).

CONCLUSION

CSGB effectively alleviates anxiety and depression in patients after thoracoscopic lung cancer surgery. The mechanisms may involve improved postoperative pain control, regulation of sympathetic nervous system function, and enhanced sleep quality. CSGB has potential dual physical and psychological intervention value in postoperative rapid recovery and warrants further clinical promotion.

Keywords: Stellate ganglion block; Thoracic surgery; Video-assisted; Lung neoplasms; Postoperative anxiety; Postoperative pain

Core Tip: In this study, we demonstrated that continuous stellate ganglion block (CSGB) was more effective than sham-CSGB in reducing postoperative anxiety and depression in patients with thoracoscopic lung cancer surgery. In summary, CSGB has dual physical-psychological benefits through the modulation of sympathetic nervous system, surgical pain relief, sleep quality improvement and early mobilization. CSGB emerges as a potential adjunct within enhanced recovery pathways, providing an innovative opportunity for optimal physiological and emotional outcomes and earlier postoperative recovery.