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

Abstract

<h4>Objective</h4>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).<h4>Methods</h4>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.<h4>Results</h4>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.<h4>Conclusion</h4>DEX-assisted ES in patients undergoing TLH under GA was effective in reducing stress response and maintaining stable hemodynamics.

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