Objective:To investigate the effects of intraoperative administration of esketamine on gastrointestinal function in patients undergoing laparoscopic total hysterectomy.Methods:A total of 150 patients undergoing laparoscopic total hysterectomy in Dingzhou People’s Hospital from Nov. 2022 to Nov. 2023 were selected as the study subjects. They were divided into the observation group ( n=75) and the control group ( n=75) based on whether esketamine was administered intraoperatively. Patients in the control group received intravenous infusion of normal saline, while those in the observation group received intravenous infusion with added esketamine. Surgical-related time courses, drug dosages, changes in heart rate (HR) , changes in mean arterial pressure (MAP) , serum intestinal fatty acid-binding protein (I-FABP) concentrations at different time points, claudin-1 concentrations at different time points, and postoperative gastrointestinal symptom rating scale scores were observed in both groups. Results:The pneumoperitoneum duration and intraoperative drug dosage were lower in the observation group than in the control group ( P<0.01) . Statistically significant differences were found between groups, time points, and interactions for HR ( P<0.001) , with HR at T2, T3, T4, and T5 being significantly lower in the observation group than in the control group ( P<0.05) . Statistically significant differences were also found between groups, time points, and interactions for MAP changes ( P<0.001) , with MAP changes at T2, T3, T4, and T5 being significantly lower in the observation group than in the control group ( P<0.05) . Statistically significant differences were observed between groups, time points, and interactions for serum I-FABP concentrations at different time points ( P<0.001) , with the serum I-FABP concentrations at 2 hours during pneumoperitoneum and after pneumoperitoneum being significantly lower in the observation group than in the control group ( P<0.05) . Similarly, statistically significant differences were found between groups, time points, and interactions for claudin-1 concentrations at different time points ( P<0.001) , with the claudin-1 concentrations at 2 hours during pneumoperitoneum and after pneumoperitoneum being significantly lower in the observation group than in the control group ( P<0.05) . The gastrointestinal symptom score was lower in the observation group than in the control group, and the time to first flatus and first defecation was shorter in the observation group ( P<0.05) . Conclusion:The intraoperative administration of esketamine in laparoscopic total hysterectomy can promote postoperative gastrointestinal function recovery, reduce gastrointestinal symptom scores, and shorten the time to first flatus and first defecation.

Objective:To investigate the effects of intraoperative administration of esketamine on gastrointestinal function in patients undergoing laparoscopic total hysterectomy.Methods:A total of 150 patients undergoing laparoscopic total hysterectomy in Dingzhou People’s Hospital from Nov. 2022 to Nov. 2023 were selected as the study subjects. They were divided into the observation group ( n=75) and the control group ( n=75) based on whether esketamine was administered intraoperatively. Patients in the control group received intravenous infusion of normal saline, while those in the observation group received intravenous infusion with added esketamine. Surgical-related time courses, drug dosages, changes in heart rate (HR) , changes in mean arterial pressure (MAP) , serum intestinal fatty acid-binding protein (I-FABP) concentrations at different time points, claudin-1 concentrations at different time points, and postoperative gastrointestinal symptom rating scale scores were observed in both groups. Results:The pneumoperitoneum duration and intraoperative drug dosage were lower in the observation group than in the control group ( P<0.01) . Statistically significant differences were found between groups, time points, and interactions for HR ( P<0.001) , with HR at T2, T3, T4, and T5 being significantly lower in the observation group than in the control group ( P<0.05) . Statistically significant differences were also found between groups, time points, and interactions for MAP changes ( P<0.001) , with MAP changes at T2, T3, T4, and T5 being significantly lower in the observation group than in the control group ( P<0.05) . Statistically significant differences were observed between groups, time points, and interactions for serum I-FABP concentrations at different time points ( P<0.001) , with the serum I-FABP concentrations at 2 hours during pneumoperitoneum and after pneumoperitoneum being significantly lower in the observation group than in the control group ( P<0.05) . Similarly, statistically significant differences were found between groups, time points, and interactions for claudin-1 concentrations at different time points ( P<0.001) , with the claudin-1 concentrations at 2 hours during pneumoperitoneum and after pneumoperitoneum being significantly lower in the observation group than in the control group ( P<0.05) . The gastrointestinal symptom score was lower in the observation group than in the control group, and the time to first flatus and first defecation was shorter in the observation group ( P<0.05) . Conclusion:The intraoperative administration of esketamine in laparoscopic total hysterectomy can promote postoperative gastrointestinal function recovery, reduce gastrointestinal symptom scores, and shorten the time to first flatus and first defecation.

Objective:To investigate the effects of conventional anesthesia combined with low dose esketamine on pain and stress response in patients undergoing laparoscopic total hysterectomy.Methods:A total of 150 patients with laparoscopic total hysterectomy admitted to our hospital from Jan. 2022 to Dec. 2023 were selected as subjects. All patients were divided into control group and study group by coin toss method, with 75 cases in each group. The control group were given conventional anesthesia, and the study group were given a small dose of esketamine. Intraoperative sedation, hemodynamics at different times, postoperative pain, stress response and the incidence of adverse reactions were compared between the two groups.Results:There was no significant difference in hemodynamics between the two groups ( P>0.05). Mean arterial pressure (MAP) was (94.84±6.02), (86.14±5.99) mmHg, systolic blood pressure (SBP) was (96.48±5.72), (96.48±5.69) mmHg; Heart rate (HR) was 95.51±5.95, 84.05±5.57 times/min, while they were 102.05±6.13, 93.71±6.25, 105.03±6.07, 104.37±6.02 mmHg, 102.49±6.87, 90.51±5.86 times/min, respectively in the control group. The study group was significantly lower than the control group ( P<0.05). SpO2 at extubation and extravasation were (97.47±1.24) % and (98.11± 1.24) % in study group and (96.32±1.21) % and (97.03±1.23) % in the control group, significantly higher than those in the control group ( P<0.05). VAS scores at 3 h, 6 h, 12 h and 24 h were 1.71±0.35, 2.58±0.53, 3.27±0.68, 3.86±0.82 in the study group and 2.13±0.42, 3.74±0.75, 4.52±1.01, 4.53±1.04 in the control group. The study group was significantly lower than the control group ( P<0.05). Study group 5-hydroxytryptamine (5-HT), substance P (SP), norepinephrine, NE) levels were 29.53±7.68, 37.44±8.16, 49.71±9.56 ng/mL, and 52.81±10.04, 54.62±10.25, 61.23±10.08 ng/mL in the control group, significantly lower than those in the control group ( P<0.05). Postoperative 2 d study group calcitonin gene related peptide (calcitonin gene related peptide, CGRP), neuropeptide Y (NPY) and cortisol (Cor) levels were 158.41±27.06 pg/mL, 127.84±24.21 pg/mL and 240.37±31.55 nmol/L. The control group was 175.49±30.28 pg/mL, 153.92±28.63 pg/mL, 251.18±34.92 nmol/L, and the study group was significantly lower than the control group ( P<0.05). The incidence of adverse reactions in the study group was 10.67% (8/75), and the control group was 16.00% (12/75), with no statistical significance ( P>0.05) . Conclusion:Conventional anesthesia combined with low-dose esketamine can help reduce intraoperative hemodynamic changes in patients with laparoscopic total hysterectomy, improve sedation effect, relieve postoperative pain, reduce postoperative pain factors and oxidative stress related indexes of patients without increasing adverse reactions, and has good efficacy and safety.

Objective To investigate the influence and mechanism of erythropoietin (EPO) in renal blood flow after limb ischemia reperfusion (LIR). Methods Thirty male SD rats were randomly divided into control group, LIR group and EPO+LIR group with ten in each group. The values of renal blood flow, plasma creatinine (Cr), urea nitrogen (BUN) content in plasma, kidney tissue wet to dry ratio (W/D), nitric oxide (NO), nitric oxide synthase (NOS) and endothelin-1 (ET-1) in re-nal tissue were detected in three groups. The immunohistochemistry assay was used to detect the expression of intercellular adhesion molecule (ICAM-1) and vascular cell adhesion molecule (VCAM-1) in renal tissue. The morphological changes of renal tissue were observed with light microscope. Results The renal blood flow was significantly decreased, while the val-ues of Cr, BUN, W/D, NO, ET-1, NOS, expressions of ICAM-1 and VCAM-1 was significantly increased in LIR group than those of control group (P<0.05). Broaden interstitial and infiltration of inflammatory cells were observed in the renal tissue under light microscope. In the EPO+LIR group, the renal blood flow increased, the values of Cr, BUN, W/D, NO, ET-1 and NOS, expressions of ICAM-1 and VCAM-1 decreased significantly compared with those of LIR group (P<0.05). The patho-logical changes were alleviated in EPO+LIR group. Conclusion EPO can improve renal function, increase renal blood flow in rats after LIR. The mechanism may be related to the decreased edema, changed renal vasomotor function and decreased in-flammation.