Journal of Practical Hepatology ›› 2020, Vol. 23 ›› Issue (3): 443-446.doi: 10.3969/j.issn.1672-5069.2020.03.035

• Cholelithiasis • Previous Articles    

Efficacy of dexmedetomidine and propofol analgesia and sedation in patients with cholecystolithiasis undergoing laparoscopic cholecystectomy

Chen Xianyu,He Chuan   

  1. Department of Anesthesiology, Provincial Central Forestry Hospital, Chengdu 610000, Sichuan Province, China
  • Published:2020-05-27

Abstract: Objective The aim of this study was to analyze the analgesic and sedative effects of dexmedetomidine and propofol combination in patients undergoing laparoscopic cholecystectomy (LC). Methods 248 patients with holecystolithiasis were admitted to the Department of Hepatobiliary Surgery in our hospital between July 2015 and May 2019, and were randomly divided into control and observation group, 124 cases in each. All the patients underwent LC, and the patients in observation group were given intravenous infusion of dexmedetomidine at 0.5 g.kg-1 10 minutes before the anesthesia induction intubation, followed by intravenous infusion of it at 0.25 g.kg-1·h-1 until the operation was completed. The patients in control group were intravenously given normal saline before the induction of anesthesia, and the other anesthetic drugs were the same except dexmedetomidine. The analgesia and sedation were evaluated by numerical rating scale (NRS) and Ramsay scale. Serum dismutase (SOD)and malonicdialdehyde (MDA) were detected by ELISA, and serum total superoxide antioxidant capacity (T-AOC) was also obtained. Results At two, six and twelve hours, the NRS score in the observation group were (2.5±0.7), (2.8±1.3) and (2.6±1.0), significantly lower than 【(3.1±0.6), (3.3±0.8) and (3.9±0.9), respectively, P<0.05】 in the control, and Ramsay scale score were (2.7±0.8), (2.7±1.0) and (2.9±1.0), significantly higher than 【(1.5±0.6), (1.9±0.5) and (2.1±0.4), respectively, P<0.05】; at five hour post-operation, serum SOD level in the observation group was (90.4±10.5) U/mL, significantly higher than 【(82.6±9.8) U/mL, P<0.05】 in the control, serum T-AOC was (15.3±2.4) U/mL, much higher than 【(12.2±2.0) U/mL, P<0.05】 in the control, while serum MDA level was (3.2±0.6) mmol/mL, significantly lower than 【(4.5±0.8) mmol/mL, P<0.05】 in the control; the incidence of adverse reactions such as nausea, vomiting and dizziness was not significantly different between the two groups (2.4% vs. 1.6%, P>0.05). Conclusion The application of dexmedetomidine and propofol combination for anesthesia in patients with cholecystolithiasis undergoing LC is efficacious for improving the perioperative analgesia and sedation, which might be related to the inhibition of oxidative stress and is worthy of clinical verification.

Key words: Cholecystolithiasis, Dexmedetomidine, Propofol, Laparoscopic cholecystectomy, Anesthesia, Oxidative stress