关键词: 胆囊结石, 腹腔镜胆囊切除术, 环泊酚, 右美托咪定, 细胞因子, 镇痛

Abstract: Objective The aim of this study was to investigate the analgesia with ciprofol and dexmedetomidine combination in patients with cholecystolithiasis undergoing laparoscopic cholecystectomy (LC). Methods 69 patients with cholecystolithiasis were enrolled in our hospital between February 2023 and June 2023, and were randomly divided into control (n=34) and observation group (n=35), and all patients in the two groups received LC. For analgesia, the ciprofol was given in patients in the control, and the ciprofol and low-dose of dexmedetomidine combination were given in patients in the observation during perioperative period. Thereafter, the aspiration anaesthesia was carried out. The visual analogue scale (VAS) and Ramsay sedation scale were applied to evaluate the anesthetic effect before intubation (T0) and 10 min after extubation (T2). The systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) were measured by multifunctional monitor at T0, 10 min after intubation (T1) and T2. Serum interleukin-1β (IL-1β), IL-6 and tumor necrosis factor-α (TNF-α) levels were measured by ELISA. Results At T2, the VAS and Ramsay scores in the observation group were (3.5±0.3) and (2.7±0.5), both significantly lower than [(3.9±0.4) and (3.3±0.5), respectively, P＜0.05] in the control; the wakening time and extubation time in the observation group were(12.4±2.7)min and (16.2±2.9)min, both significantly shorter than [(16.8±3.3)min and (19.7±3.8)min, P＜0.05] in the control; at T1, the SBP, DBP and HR were (118.7±8.6)mmHg, (71.0±6.3)mmHg and (78.8±7.4)beats/min, all significantly lower or slower than [(124.1±9.3)mmHg, (74.6±6.5)mmHg and (82.6±6.7)beats/min, P＜0.05] in the control; at T2, the SBP, DBP and HR were (121.4±10.5)mmHg, (76.6±5.9)mmHg and (76.2±6.7)beats/min, significantly lower or slower than [(127.6±10.2)mmHg, (81.6±6.1)mmHg and (80.8±8.6)beats/min, P＜0.05] in the control; 3 days after operation, serum IL-1β, IL-6 and TNF-α levels were (41.3±7.1)pg/mL, (108.9±20.5)pg/mL and (14.7±2.7)pg/mL, all significantly lower than [(46.9±8.4)pg/mL, (122.8±24.7)pg/mL and (19.2±3.9)pg/mL, respectively, P＜0.05] in the control group. Conclusion The anesthesia with cyclopofol and low-dose of dexmedetomidine combination could relieve pain and provide stable hemodynamic conditions in patients with cholecystolithiasis underwent LC, which might be related to the mild stress of body reactions.

Key words: Cholecystolithiasis, Laparoscopic cholecystectomy, Ciprofol, Dexmedetomidine, Cytokines, Analgesia