Abstract:Objective To investigate the pharmacodynamics of dexmedetomidine combined with etomidate in anesthesia for laparoscopic myomectomy, as well as the changes in hemodynamics and inflammatory factors, and to explore its clinical application value. Methods A total of 105 patients with uterine fibroids treated in Xuancheng Central Hospital from August 2020 to July 2023 were selected and divided into a low-dose group, a medium-dose group, and a high-dose group using a random number table method, with 35 patients in each group. The low-dose group received 0.20 μg/kg dexmedetomidine combined with etomidate, the medium-dose group received 0.40 μg/kg dexmedetomidine combined with etomidate, and the high-dose group received 0.60 μg/kg dexmedetomidine combined with etomidate. The mean arterial pressure (MAP), central venous pressure (CVP), stress response indicators [serum norepinephrine (NE), cortisol (Cor)], and inflammatory factor indicators [C-reactive protein (CRP), tumor necrosis factor-α (TNF-α)]were compared among the three groups at different time points. Sleep quality [Pittsburgh Sleep Quality Index (PSQI)]and the incidence of postoperative delirium (POD) were also compared among the three groups. Results Repeated measures analysis of variance showed that the levels of MAP, CVP, NE, Cor, CRP, and TNF-α in the three groups had statistically significant between-group effect, time effect, and between-group × time interaction effect (P<0.05). At 5 minutes after tracheal intubation (T1), 30 minutes after the start of surgery (T2), and at the end of surgery (T3), the MAP in the low-dose group was significantly higher than that at 15 minutes before anesthesia induction (T0) and was higher than that in the medium-dose group and high-dose group (P<0.05). At T2 and T3, the CVP in the low-dose group was significantly lower than that at T0 and T1, and was lower than that in the medium-dose group and high-dose group (P<0.05). At T1, T2, and T3, the serum levels of NE, Cor, CRP, and TNF-α in the three groups were significantly higher than those at T0, and the low-dose group had higher levels of the above indicators than the medium-dose group and high-dose group (P<0.05). On postoperative day 1, the PSQI score in the three groups was significantly higher than that before surgery, and the low-dose group had higher scores than the medium-dose group and high-dose group (P<0.05). There was no statistically significant difference in the incidence of POD among the low-dose group, medium-dose group, and high-dose group at postoperative day 3 and day 7 [postoperative day 3: 8.57% (3/35) vs 5.71% (2/35) vs 5.71% (2/35), χ 2=0.306, P=0.858; postoperative day 7: 5.71% (2/35) vs 2.86% (1/35) vs 2.86% (1/35), χ 2=0.520, P=0.771]. Conclusion The use of 0.40 μg/kg dexmedetomidine combined with etomidate in anesthesia for laparoscopic myomectomy is beneficial for maintaining stable MAP and CVP, improving stress response, inhibiting inflammatory response, and results in abetter postoperative sleep quality and a lower risk of POD.