Ultrasound-guided stellate ganglion block enhances hemodynamic stability and postoperative recovery after laparoscopic myomectomy: a randomized controlled trial

Abstract

To evaluate the effects of ultrasound-guided right stellate ganglion block (SGB) combined with propofol-based general anesthesia on perioperative hemodynamics, postoperative pain, recovery, and inflammatory stress responses in women undergoing laparoscopic myomectomy. In this single-center randomized controlled study, 240 patients scheduled for elective laparoscopic myomectomy were randomly assigned to a combined block group or a general anesthesia group. Both groups received standardized propofol-based general anesthesia. The combined block group received ultrasound-guided right-sided SGB before anesthesia induction, whereas the general anesthesia group received an equal volume of normal saline at the same anatomical site. After predefined exclusions, 117 patients in the combined block group and 116 in the general anesthesia group were included in the final analysis. Compared with the general anesthesia group, the combined block group had lower mean arterial pressure and heart rate at tracheal intubation and extubation, as well as lower low-frequency power and low-frequency/high-frequency ratio at several perioperative time points (all P < 0.05). The combined block group also showed lower median resting VAS scores at 6, 12, and 24 h, fewer PCA compressions, and a lower rescue analgesia rate (all P < 0.05). Time to first flatus and ambulation was shorter in the combined block group, while postoperative hospital stay did not differ significantly. Serum interleukin-6, cortisol, and norepinephrine levels, as well as postoperative day 1 PSQI and SAS scores, were lower in the combined block group (all P < 0.05). Postoperative nausea/vomiting, dizziness/headache, and shoulder pain were also reduced. Ultrasound-guided right-sided SGB combined with propofol-based general anesthesia was associated with improved hemodynamic stability, reduced sympathetic activation, lower early postoperative pain, attenuated inflammatory stress responses, and enhanced short-term recovery in selected women undergoing laparoscopic myomectomy. These findings should be interpreted cautiously given the single-center design, short follow-up, and retrospective trial registration. Clinical trial registration This study was retrospectively registered at ClinicalTrials.gov under the title “Ultrasound-Guided Stellate Ganglion Block Plus Propofol for Perimenopausal Insomnia With Anxiety (SGB-PROP-PIA)” (registration number: NCT07384468; first posted: 03/02/2026; protocol record: CZCH-SGB-PROP-INS-01).