Abstract: Objective To observe the effect of ultrasound-guided right stellate ganglion block （SGB） combined with dexmedetomidine （Dex） on postoperative recovery quality of patients undergoing laparoscopic total hysterectomy. Methods Sixty patients scheduled for laparoscopic total hysterectomy were randomly divided into two groups： Dex group （D group） and SGB combined with Dex group （SD group）, with 30 patients in each group. D group patients received continuous Dex infusion commencing 10 min prior to anaesthetic induction and continuing until the end of surgery. SD group patients underwent right SGB prior to anaesthetic induction, receiving 5 mL of 0.2% ropivacaine, concurrently with continuous Dex infusion initiated 10 min before induction and maintained throughout surgery. Identical anaesthetic techniques and protocols were employed for both groups. Observation indexes： （1） We recorded heart rate （HR）, mean arterial pressure （MAP）, and other parameters at pre-anaesthesia （T0）, tracheal intubation （T1）, skin incision （T2）, and extubation （T3）, as well as intraoperative anaesthetic drug consumption and tracheal tube removal time. （2） We used polysomnography （PSG） to record sleep time （SL）, total sleep time （TST）, wake after sleep onset （WASO）, sleep efficiency （SE）, and the proportions of rapid eye movement sleep （REM） on the day of operation; we administered the St Mary’s Hospital Sleep Questionnaire （SMHSQ） for both groups preoperatively, at 24 h postoperatively, and at 48 h postoperatively; we also measured 24 h cortisol levels at 7：00-8：00 am on the day of surgery and on the first day after surgery. （3） We documented analgesic rescue requirements and adverse reactions at 48 h postoperatively. Results Compared with the D group, the SD group exhibited reduced HR and MAP at T1, T2, and T3 time points （P<0.05）. The intraoperative consumption doses of propofol and remifentanil as well as the postoperative awakening and extubation time in the SD group were significantly less than those in the D group （P<0.05）. Compared with the D group, the SD group exhibited reduced SL and WASO on the night of surgery （P<0.05）, but increased TST, SE, and REM proportions （P<0.05）. Compared with the D group, the SD group exhibited significantly lower total SMHSQ scores at 24 and 48 h postoperatively （P<0.05）, and lower cortisol levels （P<0.05） at 24 h postoperatively. The proportion requiring analgesic rescue and incidence of nausea / vomiting, and dizziness were both significantly reduced in the SD group than the D group （P<0.05）. Conclusion Right SGB combined with Dex effectively ameliorates postoperative insomnia symptoms in patients undergoing laparoscopic total hysterectomy, improves sleep structure and staging, reduces postoperative gastrointestinal adverse reactions, and accelerates postoperative recovery.

Key words: Stellate ganglion block, Dexmedetomidine, Laparoscopic total hysterectomy, Sleep disorder after operation, Nausea and vomiting