Analysis of the Efficacy of Ultrasound-Guided Stellate Ganglion Block in Myomectomy

Objective To investigate the application effect of stellate ganglion block (SGB) in patients undergoing myomectomy. Methods A total of 240 patients undergoing laparoscopic myomectomy in our hospital were randomly divided into combined block group ( n =120) and general anesthesia group ( n =120). Both groups received propofol anesthesia. The combined block group underwent ultrasound-guided right-sided SGB before anesthesia induction, while the general anesthesia group received equal volume of normal saline injection at the stellate ganglion. The perioperative hemodynamics, heart rate variability, postoperative visual analog scale (VAS) pain scores, recovery process, rescue analgesia, adverse reactions, preoperative and postoperative Pittsburgh Sleep Quality Index (PSQI), Self-Rating Anxiety Scale (SAS) scores, and inflammatory stress response were compared between the two groups. Results The mean arterial pressure and heart rate at the moment of tracheal intubation and extubation, as well as the low frequency power and low frequency power/high frequency power at the moment of tracheal intubation, 5 minutes after pneumoperitoneum creation, at the end of surgery, and at extubation in the combined block group were lower than those in the general anesthesia group ( P <0.05). The VAS scores at rest at 6 h, 12 h, and 24 h postoperatively, the number of patient-controlled analgesia pump presses within 48 h, and the proportion of rescue analgesia in the combined block group were lower than those in the general anesthesia group, while the time to first flatus and ambulation was shorter than that in the general anesthesia group ( P <0.05). The levels of interleukin-6, cortisol, and norepinephrine at 24 h postoperatively in the combined block group were lower than those in the general anesthesia group ( P <0.05). The PSQI and SAS scores at 1 day postoperatively in the combined block group were lower than those in the general anesthesia group ( P <0.05). The incidence of nausea and vomiting, dizziness and headache, and shoulder pain in the combined block group was lower than that in the general anesthesia group ( P <0.05). Conclusion Stellate ganglion block in patients undergoing laparoscopic myomectomy can stabilize hemodynamics, maintain autonomic nervous system balance, improve postoperative analgesic effect, reduce inflammatory stress response and anxiety-sleep disorder symptoms, promote postoperative recovery, and has high safety.