{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T04:56:38Z","timestamp":1781585798294,"version":"3.54.5"},"reference-count":23,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T00:00:00Z","timestamp":1781568000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"\n Background<\/jats:title>\n Postoperative delirium (POD) is a common and severe complication in elderly patients following gastrointestinal oncologic surgery, associated with prolonged hospitalization, increased morbidity and mortality, and substantial healthcare costs. The stellate ganglion block (SGB), a sympathetic nerve block with anti-inflammatory and autonomic-modulating effects, has shown promise in improving perioperative outcomes. However, high-quality randomized controlled trials evaluating its efficacy in preventing POD in this older population are lacking.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This is a single-center, prospective, randomized, double-blind (participants and outcome assessors), sham- controlled trial. A total of 174 elderly patients (\u226560\u202fyears) scheduled for elective radical gastrointestinal cancer surgery will be randomized in a 1:1 ratio to receive either two ultrasound-guided SGBs (one on the afternoon before surgery and one 30\u202fmin before anesthesia induction) with 0.375% ropivacaine (3\u20135\u202fmL each) or a sham block with normal saline (3\u20135\u202fmL). All patients, surgeons, and outcome assessors will be blinded to group assignment. A standardized anesthesia protocol and a multicomponent delirium- prevention bundle will be applied to all participants. The primary outcome is the cumulative incidence of POD within postoperative days 1\u20133, assessed twice daily using the 3-Minute Diagnostic Interview for CAM-defined Delirium (3D-CAM). Secondary outcomes include delirium severity and duration, postoperative recovery (Quality of Recovery-15 score), inflammatory biomarkers (procalcitonin, C-reactive protein (CRP), interleukin-6 (IL-6), lymphocyte-to-monocyte ratio [LMR], neutrophil-to-lymphocyte ratio [NLR]), pain trajectories, opioid consumption, and length of hospital stay.<\/jats:p>\n <\/jats:sec>\n \n Expected outcomes<\/jats:title>\n We hypothesize that preoperative SGB will reduce the incidence and severity of POD compared to a sham block. This study will provide preliminary evidence on the feasibility and efficacy of SGB as a targeted intervention for high-risk older surgical oncology patients, while acknowledging that the assumed effect size may be optimistic.<\/jats:p>\n <\/jats:sec>\n \n Clinical trial registration<\/jats:title>\n \n https:\/\/www.chictr.org.cn\/showproj.html?proj=302103<\/jats:ext-link>\n , identifier: ChiCTR2600118223.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fneur.2026.1804153","type":"journal-article","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T04:27:45Z","timestamp":1781584065000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The effect of preoperative stellate ganglion block on postoperative delirium in elderly patients undergoing gastrointestinal oncologic surgery: protocol for a randomized, double-blind, sham-controlled trial"],"prefix":"10.3389","volume":"17","author":[{"given":"Rongrong","family":"Song","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, The Second Hospital & Clinical Medical School, Lanzhou University","place":["Lanzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuqin","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, The Second Hospital & Clinical Medical School, Lanzhou University","place":["Lanzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Tumor Surgery and General Surgery, Gansu Provincial Key Laboratory of Gastrointestinal Cancer, The Second Hospital & Clinical Medical School, Lanzhou University","place":["Lanzhou, China"]},{"name":"Key Laboratory of Environmental Oncology in Gansu Province, The Second Hospital & Clinical Medical School, Lanzhou University","place":["Lanzhou, China"]},{"name":"Center for Digestive System Tumor Transformation and Innovation Engineering, Environmental Oncology Center, Lanzhou University","place":["Lanzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xingyu","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Operations Management, The Second Hospital & Clinical Medical School, Lanzhou University","place":["Lanzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuqian","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, The Second Hospital & Clinical Medical School, Lanzhou University","place":["Lanzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fanli","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, The Second Hospital & Clinical Medical School, Lanzhou University","place":["Lanzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fang","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, The Second Hospital & Clinical Medical School, Lanzhou University","place":["Lanzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"XiaXia","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, The Second Hospital & Clinical Medical School, Lanzhou University","place":["Lanzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, The Second Hospital & Clinical Medical School, Lanzhou University","place":["Lanzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lu","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, The Second Hospital & Clinical Medical School, Lanzhou University","place":["Lanzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, The Second Hospital & Clinical Medical School, Lanzhou University","place":["Lanzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guojieying","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, The Second Hospital & Clinical Medical School, Lanzhou University","place":["Lanzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minghong","family":"Gui","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, The Second Hospital & Clinical Medical School, Lanzhou University","place":["Lanzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingbin","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, The Second Hospital & Clinical Medical School, Lanzhou University","place":["Lanzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiangfei","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, The Second Hospital & Clinical Medical School, Lanzhou University","place":["Lanzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,16]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1202","DOI":"10.1213\/ANE.0b013e3182147f6d","article-title":"Review articles: postoperative delirium: acute change with long-term implications","volume":"112","author":"Rudolph","year":"2011","journal-title":"Anesth Analg"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"310","DOI":"10.1007\/s005950200044","article-title":"A novel approach to the prevention of postoperative delirium in the elderly after gastrointestinal 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