To investigate the anesthetic effect of different doses of esketamine combined with sufentanil in laparoscopic radical gastrectomy for gastric cancer.

A total of 120 patients who received laparoscopic radical gastrectomy in Dongguan Integrated Traditional Chinese and Western Medicine Hospital from January 2023 to May 2024 were selected, they were divided into group A, group B and group C according to the randomly sealed envelope, with 40 cases in each group. Sufentanil and other drugs were used to induce anesthesia in the three groups, on this basis, esketamine 0.2 mg·kg^-1 in group A, 0.3 mg·kg^-1 in group B and 0.4 mg·kg^-1 in group C were used for anesthesia induction, and esketamine 0.2 mg·kg^-1·h^-1 was used to maintain anesthesia in group A, 0.3 mg·kg^-1·h^-1 was used in group B, and 0.4 mg·kg^-1·h^-1 was used group C. The perioperative conditions, hemodynamic changes, postoperative digital pain scale (NRS) score and adverse reactions were compared among three groups.

There were no statistically significant differences in the intraoperative dosage of sufentanil, ephedrine and norepinephrine among the three groups (P>0.05), the recovery time and extubation time in the group C were longer than those in the group A and group B (P<0.05), and there was no statistically significant difference in the recovery time and extubation time between group A and group B (P>0.05). The comparison of before entering the room (T0) and the end of the surgery (T3) time-point mean arterial pressure (MAP) among the three groups showed no statistical significance (P>0.05). The comparison of 5 minutes after tracheal intubation (T1) and 5 minutes after the start of the surgery (T2) time-point MAP in group A was lower than those in group B and C (P<0.05), and the comparison of T1 and T2 time-point MAP in group B showed no statistical significance (P>0.05). The comparison of heart rates at different time points among the three groups showed no statistical significance (P>0.05). There was no statistical significance in 6 h, 12 h, 24 h and 48 h NRS scores among the three groups after operation (P>0.05). There was a statistically significant difference in the incidence of agitation among the three groups (P<0.05).

In laparoscopic radical gastrectomy for gastric cancer, esketamine 0.3 mg·kg^-1 combined with sufentanil is used to induce anesthesia, and esketamine 0.3 mg·kg^-1·h^-1 is used to maintain better anesthesia effect, which can not only maintain hemodynamic stability, but also reduce the incidence of postoperative agitation.