Effects of Dexmedetomidine on postoperative pain and stress response in elderly patients undergoing laparoscopic colorectal cancer surgery / 中华老年医学杂志

ABSTRACT

Objective:To investigate the effects of Dexmedetomidine on postoperative pain and stress response in elderly patients undergoing laparoscopic colorectal cancer surgery.Methods:A total of 150 elderly patients who had undergone laparoscopic radical resection of colorectal cancer in our hospital from June 2019 to December 2020 were divided into two groups using the random number table method, the control group(n=75)and the study group(n=75). In the study group, Dexmedetomidine 0.5 μg/kg was injected intravenously over 10 min before induction of anesthesia and maintained at 0.5 μg/kg/h until 30 min before the end of surgery.Changes in heart rate, mean arterial pressure, postoperative pain and stress response index scores were compared between the two groups.Results:The MAP and HR in the study group at T1(10 min after administration), T2(immediately after endotracheal intubation), T3(30 min after pneumoperitoneum)and T4(leaving the operating room)were significantly lower than in the control group( P<0.05); The concentrations of norepinephrine and epinephrine in the study group were lower than those in the control group at T2, T3 and T4(all P<0.05); Pain scores of patients in the study group were lower than those in the control group at T4 and T5( P<0.05); Compared with the control group, the study group used less intraoperative Sufentanil[(65.5±7.0)μg vs.(76.2±7.6)μg, t=8.968, P=0.000], needed a lower number of PCIA compressions 24 h after surgery[(6.3±2.3) vs.(9.5±3.0), t=7.331, P=0.000]and had a shorter length of PACU stay[(23.4±4.0)min vs.(30.2±5.7)min, t=8.457, P=0.000]. Conclusions:Dexmedetomidine used in laparoscopic colorectal cancer surgery in elderly patients can reduce the use of sufentanil and the length of PACU stay time, improve postoperative pain scores and reduce stress response, and therefore should be recommended.