Abstract：【Objective】To investigate the anesthetic effect and cognitive function impact of dexmedetomidine(Dex) combined with propofol anesthesia in patients undergoing gallstone surgery. 【Methods】A total of 160 patients with gallstones were randomly divided into the observation group and the control group, with 80 cases in each group. Both groups underwent laparoscopic cholecystectomy(LC). Patients in the control group received intravenous propofol anesthesia, while the observation group received Dex combined with propofol anesthesia. Surgical-related indicators, hemodynamic parameters before anesthesia and after extubation [mean arterial pressure(MAP), heart rate(HR), and oxygen saturation(SpO2)], intraoperative dosages of remifentanil and propofol, mental state, pain scores, and the occurrence of adverse reactions were compared between the two groups. 【Results】There were no significant differences in surgical time and intraoperative blood loss between the two groups(P>0.05). The onset time of anesthesia, anesthesia recovery time, and recovery time of spontaneous breathing in the observation group were significantly shorter than those in the control group(P<0.05). The MAP and HR levels of both groups after extubation were lower than before anesthesia, and SpO2 level was higher than before anesthesia(P<0.05). Moreover, the MAP and SpO2 of the observation group were higher than those of the control group, while HR was lower than the control group(P<0.05). The dosages of remifentanil and propofol in the observation group were lower than those in the control group(P<0.05). The Mini-Mental State Examination(MMSE) and Visual Analog Scale(VAS) scores at 2 hours post-operation were significantly lower than at 6 hours post-operation in both groups(P<0.05). The MMSE scores at 2 hours and 6 hours post-operation in the observation group were higher than those in the control group, while the VAS scores were lower than those in the control group(P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05). 【Conclusion】 The combination of Dex and propofol for LC provides significant analgesic effects, characterized by rapid onset, recovery, and spontaneous breathing recovery. It can reduce the dosage of anesthetic drugs, maintain hemodynamic stability, and have a minimal impact on postoperative cognitive function. It is safe.
吕学良, 姜朋, 李现虎. 右美托咪定复合丙泊酚对胆囊结石手术患者的麻醉效果及认知功能的影响[J]. 医学临床研究, 2024, 41(6): 889-892.
LYU Xueliang, JIANG Peng, LI Xianhu. The Anesthetic Effect and Cognitive Function Impact of Dexmedetomidine Combined with Propofol in Patients Undergoing Gallstone Surgery. JOURNAL OF CLINICAL RESEARCH, 2024, 41(6): 889-892.
[1] HONG J T, WONG E. Gallstone ileus in ileostomy: gallstone 'Ileustomy'[J].ANZ J Surg,2022,92(5):1271-1272. [2] PULLON R M, WARNABY C E, SLEIGH J W. Propofol-induced unresponsiveness is associated with a brain network phase transition[J].Anesthesiology,2022,136(3):420-433. [3] SCHUPPER A J, SHUMAN W H, BARON R B, et al.Utilization of the American Society of Anesthesiologists(ASA) classification system in evaluating outcomes and costs following deformity spine procedures[J].Spine Deform,2021,(1):185-190. [4] 周小炫,谢敏,陶静,等.简易智能精神状态检查量表的研究和应用[J].中国康复医学杂志,2016,31(6):694-706. [5] 沈亮,胡湘,李浪平,等.PainVision法与视觉模拟评分评估腹腔镜疝修补术术后疼痛程度的相关性[J].上海医学,2016,39(6):336-339. [6] 葛新兰,唐浩文,曹俊宁,等.腹腔镜胆囊切除术后选择性腹腔引流患者延长引流时间的危险因素分析[J].中华肝胆外科杂志,2022,28(4):280-283. [7] 沈崇阅,王海雯,高瞰非,等.地佐辛对老年高血压患者腹腔镜胆囊切除术后认知功能及应激反应蛋白、神经元特异性烯醇化酶和同型半胱氨酸的影响[J].中华高血压杂志,2021,29(4):376-379. [8] 尹明明,胡知齐,张小龙.氢吗啡酮与右美托咪定联合用于腹腔镜胆囊切除术超前镇痛的效果研究[J].重庆医学,2021,50(3):406-409. [9] 张蓉,赵泽宇,王馨雪,等.瑞马唑仑复合小剂量丙泊酚用于麻醉诱导时镇静的效果[J].中华麻醉学杂志,2021,41(7):820-822. [10] 巫绍汝,吴婷婷,孙艳,等.右美托咪定对腹腔镜行结直肠癌手术老年患者术后疼痛及应激反应的影响[J].中华老年医学杂志,2021,40(11):1417-1420. [11] 欧阳辉旺,陈双全,李凌,等.右美托咪定对腹腔镜胆囊切除术患者Th1、Th2、Th17和Treg细胞因子水平的影响[J].广东医学,2021,42(8):974-978. [12] 任晓听,吴昭君.右美托咪定联合酮咯酸氨丁三醇麻醉在腹腔镜胆囊切除术中的应用效果分析[J].中国内镜杂志,2022,28(10):17-23. [13] 王凯,高红梅,贺广宝,等.右美托咪定对老年患者腹腔镜胆囊切除日间手术后早期认知功能的改善作用及机制[J].山东医药,2021,61(8):69-71. [14] 王玥,范东毅,杨禄坤.氢吗啡酮复合右美托咪定在胸腹腔镜术后静脉镇痛中的应用[J].中国新药与临床杂志,2021,40(11):764-766.
2024, Vol. 41 
