Effect of low-dose ketamine combined with dexmedetomidine on the postoperative fatigue, pain mediators and immune function in patients treated with radical cervical cancer surgery

ObjectiveTo observe the effects of low-dose ketamine combined with dexmedetomidine on the postoperative fatigue, pain mediators and immune function in patients treated with radical cervical cancer surgery.

MethodsOne hundred and fifty patients treated with radical cervical cancer surgery were selected, and divided into the observation group(n=75) and control group(n=75) by simple randomization method.Two groups were given general anesthesia.In the control group, the 0.5 μg/kg dexmedetomidine was intravenously injected before induction of anesthesia, and then the 0.5 μg·kg^-1·h^-1 was infused until before 0.5 h of operation.The observation group was injected intravenously with 0.5 mg/kg ketamin before induction of anesthesia.The general conditions during the operation, hemodynamic indexes at different time points of operation, serum levels of pain mediator and immune function indexes before and after operation, visual analog scale(VAS) score after operation, fatigue scale-14(FS-14) and mini-mental state examination(MMSE) scores before and after operation and adverse reactions of anesthesia were compared between two groups.

ResultsThe differences of the operation time, intraoperative blood loss, and intraoperative fluid supplement between two groups were not statistically significant(P>0.05).The average arterial pressure and heart rate in observation group at 1 hour during operation and at the end of operation were lower than those in control group(P < 0.05 to P < 0.01).The serum levels of serotonin, substance P, and serotonin E₂ in observation group were lower than those in control group at the end of the operation, and after 24 h and 48 h of operation(P < 0.01).The serum levels of CD3⁺, CD4⁺ and CD4⁺/CD8⁺ in observation group at the end of the operation, and after 24 h and 48 h of operation were higher than those in the control group(P < 0.01).The VAS scale scores in observation group were lower than those in control group after 24 h and 48 h of operation(P < 0.01).After 3 d and 7 d of operation, the FS-14 scores in observation group were lower than those in control group, and the cognitive function score in observation group was higher than that in control group(P < 0.01).The difference of the incidence rate of adverse reactions of anesthesia between two groups was not statistically significant(P>0.05).

ConclusionsThe application of low-dose ketamine combined with dexmedetomidine in patients treated with radical cervical cancer surgery can stabilize the hemodynamics, reduce serum pain mediator levels, reduce postoperative pain and fatigue, and improve immune function and cognitive function.