Influences of Dexmedetomidine for laparoscopic cholecystectomy on stress reaction and hepatic/renal functions / 中华老年医学杂志

ABSTRACT

Objective To explore the influences of Dexmedetomidine for laparoscopic cholecystectomy on stress reaction and hepatic/renal functions. Methods Totally 100 cases with laparoscopic cholecystectomy were divided into two groupsDexmedetormidine group and Propofol control group (n=50 for each group) according to the different anesthetic methods.The hemodynamic change,stress reaction and hepatic/renal function were measured and analyzed. Results Heart rate [(85.7±13.4)times /min vs.(62.7±9.9) times/min; (81.3±14.9) times/min vs.(60.3±8.8)times/min,t=2.296,2.714,P=0.045,0.022] and mean artery pressure(MAP )[(86.3±11.9)mm Hg vs.(66.5+11.7) mm Hg; (88.6±15.6) mm Hg vs.(68.7± 12.3) mm Hg,t=2.653,2.240,P=0.024,0.049] immediately at trachea cannula and 1 min after trachea cannula were significantly increased in Propofol control group as compared with Dexmedetomidine group.In contrast to Propofol control group,epinephrine[(680.1±112.3) pmol/L vs.(576.1±83.1)pmol/L; (705.4±127.6)pmol/L vs.648.8±105.3) pmol/L,(689.6±123.4) pmol/L vs.(628.2±94.3) pmol/L,t=2.628,2.242,2.224,P=0.019,0.039,0.040],norepinephrine[(3953.6±514.6) pmol/L vs.(3695.1±196.2) pmol/L; (3967.2=514.9) pmol/L vs.(4367.1±565.7) pmol/L; (4095.8±415.1) pmol/L vs.(3813.4 ± 513.7) pmol/L, t =2.454, 2.500, 2.255, P =0.032, 0.030,0.045] and hydrocortisone [(796.6±198.7) nmol/L vs.(698.7±176.3) nmol/L; (835.5+217.2) nmol/L vs.(783.7±201.9) nmol/L; (822.4±203.3) nmol/L vs.(720.6±188.1) nmol/L,t=2.334,2.167,2.189,P=0.033,0.044,0.043] immediately at trachea cannula,1 min and 5 min after trachea cannula were decreased in Dexmedetomidine group.There were not significantly differences in hepatic/renal function between the two groups (P＞ 0.05). Conclusions Dexmedetomidine is safe and effective for laparoscopic cholecystectomy in view of more stable hemodynamics,less stress reaction,and non influence on hepatic/renal function.