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Abstract To analyze the effects of anesthesia induction by esketamine during gynecological hysteroscopic surgery of patients on their hemodynamics and stress response. Methods: 110 patients who wanted gynecologic hysteroscopic surgeries were included and were randomly divided in group A (55 patients with sufentanil combined with propofol for anesthesia induction) and group B (55 patients with esketamine combined with propofol for anesthesia induction) from October 2019 to September 2022. The values of anesthesia related indicators (onset time of anesthesia, eye opening time, recovery time of orientation, number of body movements during operation, and propofol dosage), the values of hemodynamics indicators (MAP and HR), the postoperative pain score by VAS, the values of stress response indicators (FC, ANP, E, and NE), the MMSE score of cognitive function, and the rates of adverse reactions (nausea and vomiting, dizziness, lethargy, hypotension, and cough) of the patients were compared between the two groups. Results: The anesthetic onset time, the eye opening time, the orientation recovery time, the intraoperative body movement times, and the propofol dosage (0.69±0.17min, 2.76±0.62min, 6.59±1.49min, 1.36±0.33 times, and 85.49±6.76mg) of the patients in group B were significantly lower than those (0.87±0.21min, 4.15±1.04min, 8.54±2.01min, 1.50±0.47 times, and 97.83±8.21mg) of the patients in group A (P<0.05). The MAP values of the patients in group B after anesthesia induction, at the time of cervical dilation, after surgery, and at the time of awakening (96.55±5.38mmHg, 94.74±3.82mmHg, 96.67±4.09 mmHg, and 98.15±3.24mmHg) were significantly higher than those of the patients in group A (90.63±6.22mmHg, 86.14±4.37mmHg, 89.65±3.77mmHg, and 94.85±3.48mmHg). The HR values of the patients in group B after anesthesia induction, at the time of cervical dilation, after surgery, and at the time of awakening (80.12±4.99 times/min, 87.93±5.57 times/min, 84.15±3.89 times/min, and 79.75±4.11 times/min) were significantly lower than those (85.25±5.62 times/min, 92.54±6.00 times/min, 95.87±4.33 times/min, and 87.47±5.25 times/min) of the patients in group A (P<0.05). The VAS scores (1.25±0.27 points, 2.06±0.32 points, 2.87±0.83 points, and 2.29±0.76 points) of the patients in group B at 2, 6, 12 and 24 hours after surgery were significantly lower than those (1.71±0.34 points, 2.23±0.45 points, 3.35±1.00 points, and 3.04±0.84 points) of the patients in group A (P<0.05). The levels of FC, ANP, E, and NE (12.76±1.60 μg/dl, 0.29±0.04 nmol/L, 38.63±4.90 ng/L, and 162.78±45.87 ng/L) of the patients in group B 1 day after surgery were significantly lower than those (15.36±1.88μg/dl, 0.33±0.05 nmol/L, 45.43±6.31 ng/L, and 180.95±50.62 ng/L) of the patients in group A (P<0.05). The MMSE score (26.70±0.85 points) of the patients in group B was significantly higher than that (25.98±0.90 points) of the patients in group A (P<0.05). The incidence of adverse reactions (3.8%) of the patients in in group B was significantly lower than 12.5% of the patients in group A (P<0.05). Conclusion: Anesthesia induction by esketamine during gynecological hysteroscopic surgery of the patients has better effect, which can reduce the number of body movements and the amount of propofol used during the surgery, can stabilize the hemodynamic indicators, and can reduce the postoperative pain and stress response of the patients, and with less impacts on the cognitive function and adverse reactions of the patients.
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