Abstract: Objective To explore the effects of dexmedetomidine（Dex） on perioperative brain function in elderly patients with intrahepatic bile duct stones. Methods 72 elderly patients with intrahepatic bile duct stones were recruited in our hospital between September 2017 and June 2018,and divided into control group （n=36） and observation group（n=36）. The patients in control was given normal saline before anesthesia induction,those in observation group was given Dex. The conventional anesthesia was induced and laparoscopic hepatectomy was carried out in all the patients. The blood oxygen content（CaO2）,difference of arteriovenous blood oxygen content（Da-jvO2） and cerebral oxygen uptake rate （CERO2） were monitored before anesthesia induction （T0）,before stone removal （T1） after stone removal （T2）,at the end of surgery （T3） and at 48 h after surgery （T4）,and serum contents of neuron-specific enolase（NSE） and S100β were detected by ELISA. Mini-mental state examination （MMSE） scores were performed. Results At 12 h,24 h and 48 h after surgery,the MMSE scores were（26.3±0.5）,（27.1±0.7） and （27.6±0.2） in the observation group,much higher than [（24.8±0.6）,（25.1±0.5） and （25.4±0.4）,respectively,P<0.01] in the control; at T1 to T3,the CaO2,Da-jvO2 and CERO2,and serum contents of NSE and S100β in observation group were significantly lower than those in the control group （P<0.05）;at phase T4,the Da-jvO2,CERO2 and serum contents of NSE and S100β were （4.6±1.2） mL/dL,（24.8±3.3）%,（14.6±3.1） μg/L and（0.8±0.3）μg/L in observation group,significantly lower than[（5.8±1.6） mL/dL,（33.8±3.9）%,（17.3±4.2） μg/L and （1.4±0.4） μg /L,respectively,P<0.01] in the control. Conclusion s Dex has a protective effect on perioperative brain function in elderly patients with intrahepatic bile duct stones,which might be related to the stabilization of hemodynamic parameters,reduction of blood oxygen uptake and serum S100β and NSE contents.

Key words: Cholelithiasis, Dexmedetomidine, Hepatectomy, Perioperation, Brain function, Elderly