Abstract: Objective The aim of this study was to investigate anesthetic efficacy of dexmedetomidine in combination with propofol in patients with intrahepatic bile duct stones (IHBDS) undergoing precise hepatectomy (pHT). Methods A total of 91 patients with IHBDS were encountered in our hospital between January 2018 and December 2022, and all underwent pHT. For anesthesia, 45 patients in control group received propofol and 46 patients in observation group received dexmedetomidine and propofol combination. Parameters were routinely monitored before anesthesia induction (T0), immediately after surgery (T1), at 2 hours after surgery (T2), 6 hours after surgery (T3) and 12 hours after surgery (T4). Postoperative analgesia and sedation efficacy were evaluated by numerical rating scale (NRS) and Ramsay sedation scale (RSS), respectively. Serum cortisol (Cor), adrenocorticotropin (ACTH) and malondialdehyde (MDA) levels were detected by ELISA. Results The extubation time and awaking time in the observation group were (14.3±2.9) min and (15.7±3.8) min, significantly shorter than those in control group [(17.0±3.2) min and (18.4±4.1) min, P<0.05]; by T2, T3 and T4, dynamic NRS scores in the observation groups were (3.5±0.7) points, (3.1±0.6) points and (2.8±0.4) points, significantly lower than those in control group [(4.1±1.1) points, (3.7±0.7) points and (3.3±0.6) points, P<0.05], while RSS scores were (2.6±0.5) points, (2.8±0.6) points and (2.9±0.8) points, significantly higher than those in the control group [(1.9±0.8) points, (2.1±0.8) points and (2.2±0.9) points, P<0.05]; at T4, serum Cor, ACTH and MDA levels in the observation group were (234.1±32.7) mmol/L, (17.6±5.3) pmol/L and (3.3±0.7) mmol/mL, all significantly lower than those in the control group [(274.3±38.4) mmol/L, (25.7±6.9) pmol/L and (4.2±0.9) mmol/mL, P<0.05]. Conclusion Combiantion of dexmedetomidine and propofol could improve anesthetic efficacy, with satisfactory postoperative analgesia and sedation, which might be related to inhibition of body oxidative stress response in patients with IHBDS undergoing pHT, and is worthy of further clinical study.

Key words: Intrahepatic bile duct stones, Precise hepatectomy, Dexmedetomidine, Propofol, Anesthesia