Effect of dexmedetomidine-assisted esketamine on hemodynamics and stress level in patients undergoing total laparoscopic hysterectomy under general anesthesia.

OBJECTIVE

Hysterectomies conducted laparoscopically have risen in recent decades. Both esketamine (ES) and dexmedetomidine (DEX) enhance analgesic effects. We explored the effects of DEX-assisted ES on hemodynamics and stress levels in patients undergoing total laparoscopic hysterectomy (TLH) under general anesthesia (GA).

METHODS

Totally 100 patients undergoing TLH under GA were prospectively enrolled and equally arranged into the Research (received DEX plus ES before GA) and Control (received ES before GA) groups. Heart rate (HR) and mean arterial pressure (MAP) after admission to the operating room (T0), after anesthesia induction (T1), at endotracheal intubation (T2), at the beginning of operation (T3), and immediately after operation (T4) were documented. Serum and urine were collected to assess stress response-related indicators and hemodynamic parameters. The recovery time of spontaneous breathing, extubation time, Ramsay sedation scale score, Visual Analog Scale (VAS) score and postoperative adverse reactions were recorded.

RESULTS

HR and MAP were lower at T1 and higher at T2, T3, and T4 than T0. HR and MAP were lower at T2, T3, and T4 in the Research group than the Control group. The serum levels of cortisol (Cor) and epinephrine (EP), the norepinephrine (NE) level in the urine were elevated in all patients at T1, T2, T3, and T4 compared to T0, with the Research group demonstrating lower Cor, EP and NE than the Control group, along with reduced 12-h postoperative VAS score.

CONCLUSION

DEX-assisted ES in patients undergoing TLH under GA was effective in reducing stress response and maintaining stable hemodynamics.