Ji Xiaochen - Application analysis of stellate ganglion block in uterine fibroid removal surgery. Raw data

Objective To investigate the effectiveness of stellate ganglion block (SGB) in patients undergoing myomectomy. Methods A total of 240 patients who underwent laparoscopic myomectomy at our hospital were randomly divided into a combined block group (n=120) and a general anesthesia group (n=120). Both groups received propofol anesthesia. The combined block group underwent ultrasound-guided right-sided SGB before anesthesia induction, whereas the general anesthesia group received an 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) scores, self-rating anxiety scale (SAS) scores, and inflammatory stress response were compared between the two groups. The results The mean arterial pressure and heart rate at the time of tracheal intubation and extubation, as well as the low-frequency power and low-frequency power/high-frequency power at the time of tracheal intubation, 5 minutes after pneumoperitoneum creation, at the end of surgery, and at extubation, were lower in the combined block group than 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 pumps pressed within 48 h, and the proportion of rescue analgesia in the combined block group were lower than those in the general anesthesia group, whereas 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 postsurgery in the combined block group were lower than those in the general anesthesia group (P<0.05). The PSQI and SAS scores at 1 postoperative day were lower in the combined block group than 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 effects, reduce the inflammatory stress response and anxiety‒sleep disorder symptoms, promote postoperative recovery, and increase safety.

Keywords: Stellate ganglion block; Propofol anesthesia; Laparoscopy; Myomectomy