Perioperative Sympathetic Blockade: Mechanisms and Clinical Advances in Sensory Processing Modulation - A Narrative Review.

Surgical trauma can trigger abnormal sensory processing, which plays a central role in driving pathophysiological changes during the perioperative period. In this review, we re-examine the mechanism of sympathetic nerve blockade and suggest that its essential function may involve actively resetting the maladaptive sensory signaling pathways through multi-system interactions. We explore how the sympathetic nervous system regulates sensory input through multiple layered processes-such as sympathetic-sensory coupling, neuro-immune-endocrine interactions, and microcirculatory metabolic adjustments. The analysis further describes how nerve block techniques, including stellate ganglion block and lumbar sympathetic block, interact within these networks to produce broad therapeutic outcomes-from pain relief and stress modulation to organ protection. Finally, we highlight potential future advances in precision-oriented sympathetic intervention, guided by neural circuit mapping, biomarker monitoring, and artificial intelligence.