Objective To observe the effect of lumbar muscle block under ultrasound guidance on the overall benefit level of patients with laparoscopic total hysterectomy under ultrasound, in order to provide scientific reference opinions for the blocking method of relevant patients. Methods The 98 patients who underwent laparoscopic total hysterectomy admitted to our hospital from January 2020 to January 2022 were divided into the control group and the research group, 49 cases each. The control group adopted anterior lumbar muscle block, and the study group adopted ultrasound-guided transgillary ligament lumbar muscle block to compare the anesthesia-related conditions, pain (resting and activity (coughing)), anesthesia drug use, postoperative recovery, adverse reactions and block complications. Results Compared with the control group, there were more blocking time blocks and blocking planes at different points after blocking in the study group (P＜0.05), and the block operation time between the two groups (P＞0.05). In both states of rest and activity, the pain score in the study group was lower than that in the control group (P＜0.05). The dosage of propofol in the two groups,(P＞0.05) The dosage of remifentanil in the research group was less than that in the control group (P＜0.05). The postoperative sex activity, initial anal exhaust, and the first eating time of the research group were all earlier than that of the control group, and the hospitalization time was shorter than that of the control group (P＜0.05). Comparison of the occurrence of adverse reactions and block complications in the two groups (P＞0.05) Conclusion Patients with laparoscopic total hysterectomy adopt ultrasound-guided lumbar lateral muscle blocking through arch ligament, which blocks and a large number of blocking planes in a short period of time are conducive to alleviating the patient's postoperative pain, promoting comfort, accelerating postoperative recovery, and being safe and reliable