Abstract:

Objective To investigate the effect of dexmedetomidine on stress response in elderly patients undergoing laparoscopic cholecystectomy under general anesthesia. Method The clinical data of 70 elderly patients with laparoscopic cholecystectomy under general anesthesia treated in Jiangning Hospital Affiliated to Nanjing Medical University from January 2021 to February 2022 were retrospectively analyzed. According to different anesthesia intervention methods, they were divided into control group and study group, with 35 cases in each group. The patients in the control group were treated with propofol, and the patients in the study group were treated with dexmedetomidine hydrochloride injection. The hemodynamic indexes, stress indexes and operation conditions of the two groups were compared before anesthesia induction (T0), during tracheal intubation (T1), during pneumoperitoneum establishment (T2), during tracheal extubation (T3) and 5min after extubation (T4). Result The heart rate and mean arterial pressure of the study group at T0 ～ T3 were lower than those of the control group (P ＜ 0.05), and there was no significant difference between the two groups at T4 (P ＞ 0.05). The level of plasma cortisol in the study group at T0 ～ T3 was lower than that in the control group (P ＜ 0.05), and the level of angiotensin Ⅱ in the study group at T4 was lower than that in the control group (P ＜ 0.05), and there was no significant difference between the two groups at T4 and at T0 ～ T3 (P ＞ 0.05). The duration of pain, time of getting out of bed, time of abdominal drainage tube removal and hospital s tay in the study group were shorter than those in the control group (P ＜ 0.05). Conclusion Dexmedetomidine used in elderly patients undergoing laparoscopic cholecystectomy under general anesthesia can improve hemodynamic and stress indicators, shorten the duration of pain, out of bed and hospitalization, and is conducive to postoperative recovery.

Key words: Dexmedetomidine, Elderly patients, Laparoscopic cholecystectomy, Stress response, Hemodynamics