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Abstract To analyze the effects of general anesthesia combined with dexmedetomidine during laparoscopic total hysterectomy of patients on their perioperative stress response and postoperative cognitive function. Methods: A total of 140 patients who wanted elective laparoscopic hysterectomy were selected and were randomly divided into two groups (70 cases in each group) according to the random number table from March 2019 to March 2021. The patients in the control group were treated with routine general anesthesia during operation, while the patients in the observation group were treated with dexmedetomidine combined with general anesthesia during operation. The levels of serum stress response indexes, such as cortisol (Cor), angiotensin II (AngⅡ), endothelin (ET), superoxide dismutase (SOD), and malondialdehyde (MDA) of the patients before anesthesia (T0), during operation (T1), and postoperative 1h (T2) were compared between the two groups. Postoperative consciousness and cognitive function of the patients were assessed by observer assessment of sedation (OAAS) and mini-mental state examination (MMSE). The rate of adverse reactions of the patients in two groups were counted. Results: The levels of serum Cor, Ang Ⅱ, ET, and MDA of the patients in the two groups at T1 and T2 were significantly lower than those of the patients at T0, and the level of SOD of the patients in the two groups at T1 or T2 was significantly higher than that at T0. The levels of serum Cor, Ang Ⅱ, ET, and MDA of the patients in the observation group at T1 and T2 were significantly lower than those of the patients in the control group, and the level of SOD of the patients in the observation group at T1 or T2 was significantly higher than that of the patients in the control group (all P<0.05). The OAAS scores of the patients in the two groups at the end of operation, at the time of extubation, and at T2 had increased gradually, and which of the patients in the observation group were significantly higher than those of the patients in the control group. The MMSE scores of the patients in the two groups at T2, at postoperative 4h and 12h had increased gradually, and which of the patients in the observation group were significantly higher than those of the patients in the control group (all P<0.05). The incidence of POCD (2.9%) of the patients in the observation group was significantly lower than that (14.3%) of the patients in the control group (P>0.05), and the incidence of adverse reactions (5.7%) of the patients in the observation group had no significant different from that (8.6%) of the patients in the control group (P<0.05). Conclusion: Dexmedetomidine combined with general anesthesia during laparoscopic total hysterectomy can effectively reduce the stress response of the patients, which is conducive to the recoveries of postoperative consciousness and cognitive function of the patients with higher safety.
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