Analgesic and hemodynamic effects of two injection approaches of dexmedetomidine in elderly cholecystolithiasis patients undergoing laparoscopic cholecystectomy: a retrospective study of 150 patients.

This retrospective study investigated the effects of three dexmedetomidine (Dex) injection approaches on analgesic and hemodynamics in elderly cholecystolithiasis patients undergoing laparoscopic cholecystectomy. The clinical data of 150 elderly patients with cholecystolithiasis were collected, and they were divided into the Dex A (n=50), Dex B (n=50), and Dex C (n=50) cohorts. Patient's heart rate (HR) and mean arterial pressure (MAP) were collected at T0, T1, and T2 for blood gas analysis. The difference in oxygen content between cerebral arterial and venous blood (Da-jvO2) was calculated. The duration of surgery, occurrence of cardiovascular and respiratory suppression, and the time of spontaneous respiratory recovery and extubation were recorded. At T2, T3, and T4, HR and MAP in the Dex C group were smaller than Dex A group and Dex B group (Dex C<Dex B<Dex A, P<0.05); at T5, HR and MAP in the Dex C group were smaller than Dex A group and Dex B group (P<0.05). At T1 and T2, SjVO2 in the Dex C was smaller than the Dex A group and the Dex B group (P<0.05); Da-jvO2 in Dex C group was more remarkable than group A and group B, and group B was more incredible than Dex A at T1 and T2 (P<0.05). Dex is beneficial in reducing cerebral oxygen metabolism and maintaining hemodynamic stability in elderly patients undergoing cholecystectomy during the perioperative period. The combination of the loading and maintenance dose has a better effect.