| Objective: To observe the effects of different doses of dexmedetomidine (Dex) combined with nerve block anesthesia on stress response factors and postoperative cognitive function in patients undergoing gynecological laparoscopic surgery. Methods: 160 patients who underwent gynecological laparoscopic surgery were admitted to the Yibin Second People''s Hospital from January 2023 to June 2023 were included as the study subjects, patients were divided into low dose group (n=53, 0.2μg.kg.h-1), medium dose group (n=53, 0.4μg.kg.h-1), and high dose group (n=54, 0.8μg.kg.h-1) based on the dosage of Dex pump. The pain visual analogue (VAS) score, Ramsay sedation score, hemodynamics, stress response factors and cognitive function indexes and the incidence of adverse reactions were compared in three groups. Results: 12 hours after operation, the Ramsay in high dose group was higher than that in medium dose group, high dose and medium dose groups were higher than that of low dose group (P<0.05). 12 hours after operation, the VAS score in high dose group was lower than that in medium dose group, high dose and medium dose groups were lower than that of low dose group (P<0.05). 5 minutes after extubation, the heart rate (HR) and mean arterial pressure (MAP) in high dose group were lower than those in medium dose group, high dose and medium dose groups were lower than those of low dose group (P<0.05). 5 minutes after extubation, superoxide dismutase (SOD) in high dose group was higher than that in medium dose group, high dose group and medium dose group were higher than that of low dose group (P<0.05). 5 minutes after extubation, norepinephrine (NA), adrenocorticotropic hormone (ACTH) and malondialdehyde (MDA) in high dose group were lower than those in medium dose group, high dose and medium dose groups were lower than those of low dose group (P<0.05). 12 hours after extubation, the scores of mini-mental state examination (MMSE) in high dose group and medium dose group were higher than that in low dose group, and high dose group was higher than that of medium dose group (P<0.05). The incidence of postoperative cognitive dysfunction (POCD) in high dose group was lower than that in low dose group and medium dose group (P<0.05). Conclusion: The application of Dex in gynecological laparoscopic surgery shows a dose dependent effect, with a dose of 0.8μg.kg.h-1 showing better results, which can significantly reduce the degree of stress injury and the incidence of POCD in patients, alleviate pain after operation, and increase the stability of perioperative hemodynamics. |
