To observe the clinical efficacy and safety of dexmedetomidine injection combined with esketamine injection in the treatment of patients with oral squamous cell carcinoma radical resection.

Patients with oral squamous cell carcinoma radical resection were randomly divided into treatment and control groups. The treatment group will receive intravenous administration of 0.6 μg·kg^-1 dexmedetomidine 10 minutes before anesthesia induction. Subsequently, anesthesia induction will be performed with intravenous administration of 0.5 mg·kg^-1 esketamine. Anesthesia maintenance will be achieved with intravenous infusion of 0.25 mg·kg^-1·h^-1 esketamine and 0.3 μg·kg^-1·h^-1 dexmedetomidine used an infusion pump. The control group will receive intravenous administration of an equivalent volume of 0.9% NaCl 10 minutes before anesthesia induction. Anesthesia induction will then be performed with intravenous administration of 2.5-5.0 μg·kg^-1 fentanyl. Anesthesia maintenance will involve intravenous infusion of 0.10-0.25 μg·kg^-1·min^-1 remifentanil used an infusion pump. The anesthesia effectiveness, analgesic effectiveness, hemodynamics and safety were compared between the two groups.

Treatment group were enrolled 62 cases, 1 case dropped out, and 61 cases were finally included in the statistical analysis. Control group were enrolled 61 cases, 1 case dropped out, and 60 cases were finally included in the statistical analysis. The recovery room stay time of treatment and control groups was (25.97±4.52) and (18.39±3.64) min, the extubation time was (16.75±4.84) and (10.16±3.18) min, and the differences were statistically significant (all P<0.05). After operation 24 h, visual analogue scores of treatment and control groups were (0.85±0.17) and (1.39±0.25) points, adrenocorticotropin levels were (60.07±7.13) and (72.64±9.81) pg·mL^-1, cortisol levels were (481.20±49.15) and (539.94±57.77) nmol·L^-1, and the differences were statistically significant (all P<0.05). The mean arterial pressure at 30 min after anesthesia induction (T1) and at the end of surgery (T2) in treatment group were (82.34±4.98) and (86.57±4.18) mmHg, while those in control group were (77.25±7.16) and (76.02±6.29) mmHg; the heart rates of T1 and T2 in treatment groups were (64.08±4.19) and (66.45±4.83) time·min^-1, while those in control group were (68.44±6.02) and (72.08±7.27) time·min^-1; and the differences were statistically significant (all P<0.05). The adverse drug reactions in two groups were nausea, vomiting, bradycardia and dizziness. The total incidences of adverse drug reactions in treatment and control groups were 8.20% and 15.00%, without significant difference (P>0.05).

Dexmedetomidine injection combined with esketamine injection has a definitive analgesia efficacy in the treatment of patients with oral squamous cell carcinoma radical resection, which can significantly reduce stress responses, maintain hemodynamic stability, without increasing the incidence of adverse drug reactions.