Ultrasound-Guided Stellate Ganglion Block Plus Propofol for Perimenopausal Insomnia With Anxiety

Laparoscopic myomectomy is a commonly performed minimally invasive gynecologic procedure. However, surgical trauma, tracheal intubation, and pneumoperitoneum may induce pronounced perioperative stress responses, resulting in hemodynamic instability, postoperative pain, inflammatory activation, sleep disturbance, and anxiety, which can delay postoperative recovery. Stellate ganglion block (SGB) is a sympathetic nerve modulation technique that has been shown to attenuate stress-related sympathetic overactivity. This study aimed to evaluate the clinical effects and safety of ultrasound-guided right-sided stellate ganglion block combined with standardized general anesthesia in patients undergoing laparoscopic myomectomy. In this randomized controlled study, a total of 240 patients scheduled for laparoscopic myomectomy were randomly assigned to either a combined block group (ultrasound-guided right-sided SGB before anesthesia induction plus general anesthesia) or a general anesthesia group (sham saline injection plus general anesthesia). Perioperative hemodynamic parameters, heart rate variability, postoperative pain scores, analgesic requirements, recovery profiles, inflammatory stress markers, sleep quality, anxiety levels, and adverse events were compared between groups. This study was retrospectively registered after completion. The results are intended to provide evidence for optimizing perioperative management and enhancing recovery in patients undergoing laparoscopic myomectomy.

Sex

Female

Minimum age

35 Years

Maximum age

55 Years

Inclusion Criteria:

* Female patients aged 35 to 55 years.
* Diagnosed with uterine fibroids and scheduled for elective laparoscopic myomectomy.
* American Society of Anesthesiologists (ASA) physical status classification I or II.
* Normal cognitive function and ability to understand the study procedures.
* Provided written informed consent prior to participation.

Exclusion Criteria:

* Contraindications to stellate ganglion block, including coagulation disorders, infection at the puncture site, or allergy to local anesthetics.
* Severe dysfunction of major organs, including heart, liver, or kidney.
* Poorly controlled chronic diseases such as hypertension or diabetes mellitus.
* History of psychiatric disorders, chronic pain conditions, or long-term use of sedatives, analgesics, or medications affecting autonomic nervous system function.
* Preexisting significant sleep disorders prior to surgery.
* Abnormal cervical anatomy, history of cervical surgery, or radiotherapy.
* Anticipated difficult airway.
* Conversion to open surgery during the procedure.
* Failure of stellate ganglion block.
* Occurrence of serious adverse events related to the block procedure, such as nerve injury, arrhythmia, or local anesthetic systemic toxicity.
* Unplanned admission to the intensive care unit after surgery.