Pakistan Journal of Pharmaceutical Sciences

Abstract: Background: Selecting appropriate anesthetic agents and techniques that ensure hemodynamic stability and attenuate perioperative stress responses is crucial for ovarian cancer surgery. Objectives: This study aimed to evaluate the effects of etomidate combined with transversus abdominis plane block (TAPB) on perioperative hemodynamics, inflammatory and oxidative stress responses and immune function in patients undergoing radical resection of ovarian cancer. Methods: A total of 80 patients were randomly assigned to receive total intravenous anesthesia (TIVA) alone or TIVA combined with TAPB. Hemodynamic parameters, serum inflammatory markers, oxidative stress indicators, pain mediators, immune cell subsets and adverse reactions were compared between the two groups. Results: Perioperative hemodynamic parameters changed dynamically in both groups, with heart rate and mean arterial pressure increasing intraoperatively and decreasing postoperatively. However, the research group had significantly lower heart rate and mean arterial pressure than the control group during the peak intraoperative period (P<0.001), indicating improved hemodynamic stability. Preoperative levels of inflammatory, oxidative stress, pain-related and immune indexes were comparable between groups (P>0.05). At 24 h postoperatively, the research group showed significantly reduced serum levels of high-sensitivity C-reactive protein, tumor necrosis factor-?, malondialdehyde, cortisol, prostaglandin E2 and substance P compared with the control group (all P<0.05), reflecting attenuation of systemic inflammation, oxidative stress and nociceptive activation. Postoperative immune function was better preserved in the research group, as evidenced by higher CD3+ and CD4+ cell counts and CD4+/CD8+ ratio, along with a lower CD8+ level (P<0.05). The overall incidence of adverse reactions was low and did not differ significantly between groups (4.4% vs 8.9%, P>0.05). Conclusion: Etomidate combined with transversus abdominis plane block provides stable anesthesia and modulates perioperative inflammatory and immune responses while reducing postoperative biochemical pain mediator levels, thereby supporting a safer and more physiologically balanced recovery following ovarian cancer surgery.