The Impact of Dexmedetomidine Doses on Postoperative Cognitive Dysfunction and Inflammatory Response in Elderly Female Patients Undergoing Laparoscopic Cholecystectomy

Abstract

Objective To investigate how different dexmedetomidine (Dex) doses affect postoperative cognitive function and inflammatory markers in elderly female patients receiving laparoscopic cholecystectomy (LC). Methods Based on the inclusion criteria, 165 elderly patients undergoing LC in our hospital were divided into four groups: Group C (32 patients), Group D1 (41 patients), Group D2 (49 patients), and Group D3 (43 patients). Patients in Group C were administered saline during anesthesia induction and anesthesia maintenance, whereas those in Group D were administered a 0.5 µg/kg Dex infusion 15 minutes before anesthesia induction, followed by postoperative infusions of 0.4, 0.6, and 0.8 µg/(kg·h) Dex for anesthesia maintenance. The effects of different Dex doses on postoperative cognitive impairment, pain scores, and inflammatory markers were studied in the selected patients. Results 1. Postoperative cognitive dysfunction (POCD) was less common in Dex groups compared to Group C (P < 0.05). 2. On the first day after surgery, the VAS pain scores in all Dex groups were lower than those in Group C (P < 0.05); on the second and third days after surgery, the visual analog scale scores in Groups D2 and D3 were lower than those in Group C (P < 0.05); 3. Dex alleviated postoperative insomnia; 4. In the Dex groups, pro-inflammatory cytokine levels decreased postoperatively whereas anti-inflammatory cytokine levels increased. Conclusion Dex has been shown to lower the incidence of POCD and ameliorate early postoperative pain in elderly female patients after LC, a process that may be related to the control of postoperative inflammatory responses.