Demographic and intraoperative characteristics.

BackgroundPostoperative visceral pain remains a major challenge following laparoscopic hysterectomy. While stellate ganglion block (SGB) is increasingly utilized for acute and chronic pain management, limited evidence exists regarding its efficacy in modulating visceral pain after gynecologic laparoscopy. This study aimed to evaluate whether ultrasound-guided SGB could reduce early postoperative visceral pain intensity and opioid consumption.MethodsIn this prospective, randomized controlled trial, 90 patients undergoing laparoscopic hysterectomy were allocated (1:1:1) to receive ultrasound-guided SGB combined with transversus abdominis plane block (TAPB) (SGB group), TAPB alone (TAP group), or no nerve block (control group). The primary outcome was visceral pain intensity, assessed using visual analog scale (VAS) scores at rest and during movement at 1, 3, 6, 24, and 48 hours postoperatively. Secondary outcomes included rescue analgesia requirements and complications.ResultsThe linear mixed-effects model revealed that the SGB group exhibited a significantly greater reduction in visceral pain intensity at rest and during movement at 1, 3, and 6 hours compared to the TAP and control groups (P P P > 0.05).ConclusionUltrasound-guided SGB effectively alleviates early postoperative visceral pain and reduces opioid demand, supporting its role as a valuable addition to multimodal analgesia protocols in laparoscopic hysterectomy.背景：术后内脏痛仍是腹腔镜子宫切除术（laparoscopic hysterectomy）后面临的主要难题。尽管星状神经节阻滞（stellate ganglion block, SGB）在急慢性疼痛管理中的应用日益广泛，但目前关于其在妇科腹腔镜手术后调节内脏痛的疗效证据仍较为有限。本研究旨在评估超声引导下星状神经节阻滞是否可降低术后早期内脏痛强度与阿片类药物消耗量。方法：本项前瞻性随机对照试验共纳入90例行腹腔镜子宫切除术的患者，按1:1:1比例随机分为三组：超声引导下星状神经节阻滞联合腹横肌平面阻滞（transversus abdominis plane block, TAPB）组（SGB组）、单纯腹横肌平面阻滞组（TAP组）以及空白神经阻滞对照组（对照组）。主要结局指标为内脏痛强度，分别于术后1、3、6、24及48小时采用视觉模拟评分法（visual analog scale, VAS）评估静息状态与活动状态下的疼痛评分。次要结局指标包括补救镇痛需求与并发症发生情况。结果：线性混合效应模型分析显示，与TAP组及对照组相比，SGB组在术后1、3、6小时的静息及活动状态下内脏痛强度均出现更为显著的降低（P P P > 0.05）。结论：超声引导下星状神经节阻滞可有效缓解术后早期内脏痛并减少阿片类药物需求量，证实其可作为腹腔镜子宫切除术多模式镇痛方案中极具价值的补充手段。