目的 探讨超声下星状神经节阻滞（SGB）对全麻机器人前列腺癌根治术（RALRP）中应激反 应及术后早期恢复质量的影响。方法 选取择期行 RALRP 的患者 116 例，随机分为研究组（S 组）和对照 组（C 组）。S 组在麻醉诱导前接受超声下 SGB，C 组以同法注射等量生理盐水。比较两组入室后（T0）、气 管插管（T1）、气腹后 1 min（T2）、10 min（T3）、20 min（T4）和术毕（T5）时的心率（HR）与平均动脉压（MAP）；于 T0、T2、T4和术后 2 h（T6）时检测静脉血浆皮质醇（Cor）、肾上腺素（E）与去甲肾上腺素（NE）浓度；比较两组 术后 NRS 疼痛评分、镇痛药用量、认知功能 MMSE 评分、术后早期恢复指标和不良反应。结果 与 C 组比 较，S 组于 T1和 T2时 HR 和 MAP 显著降低（P < 0.05）；S 组在 T2、T4和 T6时 Cor 水平以及 T2和 T4时 E 和 NE 水 平明显低于 C 组（P < 0.05）；而术后 NRS 评分、镇痛药用量和 MMSE 评分均差异无统计学意义（P > 0.05）； S 组术后肠鸣音恢复时间、首次肛门排气时间及总不良反应发生率明显降低（P < 0.05）。结论 超声下 SGB 可降低RALRP 中血流动力学波动，抑制应激反应，减少不良反应，促进术后肠道功能恢复。

Objective To investigate the effects of ultrasound ⁃ guided stellate ganglion block（SGB）on stress response and early recovery quality of elderly patients undergoing robot⁃assisted laparoscopic radical prostatec⁃ tomy. Methods A total of 116 elderly patients scheduled for RALRP were selected and randomly divided into study group（group S）and control group（group C）. Group S received ultrasound⁃guided SGB before induction of anesthe⁃ sia，and group C was treated with normal saline in the same way. The heart rate（HR）and mean arterial pressure （MAP）were recorded and compared between the two groups at the time points of before anesthesia induction（T0）， immediately after tracheal intubation（T1），1 min（T2），10 min（T3），20 min（T4）after pneumoperitoneum and at the end of surgery（T5）. The concentration of serum cortisol（Cor），epinephrine（E）and norepinephrine（NE）were measured and compared as well at T0，T2，T4 and 2 h after surgery（T6）. The NRS pain scores，the consumption of sufentanil within 48 h after surgery and the（MMSE）scores on preoperative day（D0）and day 1（D1），day 3（D3）， day 5（D5）after surgery were recorded. The two groups were compared in terms of the NRS pain scores after surgery， consumed amount of sufentanil，scores of Mini ⁃mental State Examination（MMSE），early recovery index and inci⁃ dence of adverse reactions. Results Compared with group C，HR and MAP in group S were significantly decreased at T1 and T2（P < 0.05）. Group S presented remarkably lower concentrations of plasma Cor at T2，T4 and T6；and lower concentrations of plasma E and NE at T2 and T4（P < 0.05）. No statistical difference was found in the NRS scores， the consumption of sufentanil after the operation and MMSE scores between the two groups（P > 0.05）. Group S showed significantly shorter recovery time of bowel sounds and the first anal exhaust time and lower incidence of adverse reactions compared with group C. Conclusion Ultrasound⁃guided SGB can inhibit the stress response，reduce the incidence of adverse reactions and accelerate the recovery of intestinal function in elderly patients undergoing RALRP.