Effect of Dexmedetomidine Combined with Esketamine on Postoperative Fatigue in Patients Undergoing Total Laparoscopic Hysterectomy: A Single-Center Randomized Double-Blinded Controlled Trial.

Abstract

<h4>Purpose</h4>The purpose of this experiment is to study the impact of dexmedetomidine combined with esketamine on postoperative fatigue in patients who undergo total laparoscopic hysterectomy.<h4>Patients and methods</h4>A total of 176 patients who received elective total laparoscopic hysterectomy were included in the study and divided into four groups: control group (Group C), dexmedetomidine group (Group D), esketamine group (Group E), and dexmedetomidine combined with esketamine group (Group DE). Group D received dexmedetomidine intervention, Group E received esketamine intervention, and Group DE received the combined intervention of dexmedetomidine and esketamine. The primary outcome was the 10-item Identity-Consequence Fatigue Scale (ICFS-10) scores, which were assessed before surgery and on postoperative days 3, 5, 7, and 30. Secondary outcomes included postoperative Visual Analog Scale (VAS) scores, Pittsburgh Sleep Quality Index (PSQI) scores, extubation time, first postoperative ambulation time, first postoperative flatus time, and nausea and vomiting incidence among four groups.<h4>Results</h4>Compared with Group C, Groups D, E, and DE had lower scores on ICFS-10 and PSQI on postoperative days 3, 5, and 7, as well as lower movement VAS scores at the postoperative 24 and 48 hours (<i>p<</i>0.05). A lower fatigue incidence was also observed in Group DE on postoperative days 3, 5, and 7. Group DE showed a reduced rate of adverse events (vasoactive drug administration, postoperative nausea and vomiting, and requirement for rescue analgesia) compared with Group C (<i>p<</i>0.05). No intergroup differences in ICFS-10 scores or fatigue incidence were found on postoperative day 30 (<i>p></i>0.05).<h4>Conclusion</h4>For patients undergoing total laparoscopic hysterectomy, the combined use of dexmedetomidine and esketamine enhances early postoperative fatigue levels and lowers the incidence of fatigue. However, this combination has no significant effect on fatigue on postoperative day 30.

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