Abstract:

Objective To evaluate the clinical efficacy of stellate ganglion block （SGB） combined with intranasal dexmedetomidine for the treatment of insomnia. Methods A total of 64 patients aged 18 to 75 with insomnia were randomly assigned to either the experimental group （DS group） or the control group （S group）. The S group received SGB treatment for 14 consecutive days， whereas the DS group received an additional intranasal dexmedetomidine spray at a dose of 100 μg， administered 30 minutes before bedtime on days 1 through 6， in conjunction with SGB. We measured and recorded the Pittsburgh Sleep Quality Index （PSQI）， Self?Rating Depression Scale （SDS）， Self?Rating Anxiety Scale （SAS） scores， and Psychomotor Vigilance Test （PVT） results for both groups at three time points： baseline （T₁）， the day after treatment （T₂）， and one month after treatment （T₃）. Results Intra?group Comparison： In both the DS and S groups， PSQI scores and dimensionspecific scores at T₂ and T₃ were significantly lower compared to T₁ （P < 0.05）. SAS and SDS scores in both groups showed a significant reduction at T₃ compared to T₁ and T₂ （P < 0.05）， while PVT results exhibited no significant changes（P > 0.05）. Inter?group Comparison： The PSQI scores and dimensionspecific scores in the DS group at T₂ （8.44 ± 2.99） and T₃ （8.22 ± 2.60） were significantly lower than those in the S group at T₂ （10.88 ± 2.56） and T₃（10.88 ± 2.84） （P < 0.05）. However， no significant differences were observed in SDS and SAS scores between the DS and S groups at T₂ and T₃ （P > 0.05）. Conclusion Compared to standalone SGB， the combination of SGB with intranasal dexmedetomidine significantly enhances sleep quality in patients with insomnia， while not impacting their levels of anxiety， depression， or alertness.

Key words: stellate ganglion block, intranasal dexmedetomidine spray, insomnia disorders