Ultrasound-guided stellate ganglion block in the sitting position for insomnia treatment: a randomized controlled trial

Background‌ Stellate ganglion block (SGB) is usually performed in a supine or lateral position; this is unsuitable for patients with mobility impairments. This study aimed to assess the clinical efficacy of ultrasound-guided SGB in the sitting position compared to supine position for insomnia management. Methods 181 patients with refractory insomnia were randomized to receive 7 sessions of SGB in either the supine (group A, 86 cases) or sitting (group B, 95 cases) position. All patients received in-plane needle insertion ultrasound-guided technique. The primary outcomes included procedural difficulty and success rate; secondary outcomes encompassed patient comfort, psychological stress, sleep qualitymetrics, therapy efficacy, and adverse events. Results All SGB procedures were successfully completed with minimal technical difficulty, the operation time and the success rate was similar between groups ( P > 0.05). Sitting position significantly offered better comfort and less psychological stress( P < 0.05). Both groups achieved better sleep quality and remarkable outcome ( P < 0.05), but no significant differences were observed in sleep parameters or adverse events between groups ( P > 0.05). Conclusion Ultrasound-guided sitting SGB provides superior patient comfort and psychological benefits while maintaining clinic efficacy and safety comparable to supine positioning in insomnia treatment.