To explore the effects of ultrasound-guided stellate ganglion block (SGB) combined with dexmedetomidine on postoperative inflammatory factor levels and fast-track recovery in elderly patients undergoing laparoscopic cholecystectomy (LC).

From January 2024 to April 2025, 80 elderly patients undergoing LC in the Affiliated Chuzhou Hospital of Anhui Medical University (the First People’s Hospital of Chuzhou) were selected and randomly allocated to a trial group and a control group, each comprising 40 cases. The trial group received right-sided SGB under ultrasound guidance with 6 ml of 0.3% ropivacaine injection, and a loading dose of dexmedetomidine at 0.5 μg/kg was administered 10 minutes before surgery. The infusion was completed within 10 minutes and then continued at a constant rate of 0.5 µg·kg^-1·h^-1 until 15 minutes before the end of surgery. The control group received the same volume of normal saline at the same site, and the use of dexmedetomidine was the same as in the trial group. The levels of inflammatory factors (IL-6, TNF-α, IL-10) were compared between the day before surgery, the 1st postoperative day, as well as the Pittsburgh sleep quality index (PSQI) on the day before surgery, postoperative day 1 and 2, the visual analog scale (VAS) scores for pain at 6, 12, and 24 h postoperatively, and the incidence of postoperative adverse reactions.

One day after surgery, the control group showed increased IL-6 and TNF-α and decreased IL-10 (all P<0.05). In the trial group, only IL-6 increased (P<0.05), remaining lower than in controls, while TNF-α was also lower and IL-10 higher (all P<0.05). PSQI rose in the control group on postoperative day 1 and 2, whereas the trial group increased only on the 1st day and stayed below controls (all P<0.05). VAS scores were consistently lower in the trial group at 6, 12, and 24 h postoperatively (all P<0.05), and the incidence of postoperative nausea and vomiting (PONV) was lower than in the control group (P<0.05).

Ultrasound-guided SCB combined with dexmedetomidine can effectively inhibit the excessive release of inflammatory factors in elderly patients following LC, reduce postoperative pain, improve sleep quality, decrease the incidence of PONV, and promote fast-track recovery with good safety. It has important clinical application values and a broad application prospect.