Abstract：Objective:To evaluate the role of dexmedetomidine in the perioperative inhibition of inflammation and early recovery in elderly patients undergoing hepatectomy.Methods: One hundred and fifty elderly patients, regardless of gender, with BMI 18.5 to 24.9 kg/m2, 65 to 80 years old, ASA grade II or III, and Child-pugh grade A or B, were proposed for elective hepatectomy. A random number table was used to simply randomly divide the enrolled cases into two parts: an experimental group and a control group, each with 75 cases. In the experimental group, dexmedetomidine 0.2 μg/(kg-h) was continuously pumped and maintained until 30 min before the end of surgery; in the control group, the same dose of 0.9% NaCl was pumped intravenously at the same rate. The MAP and HR were recorded at room entry (T0), skin incision (T1), start of liver incision (T2), completion of liver incision (T3), and end of surgery (T4). 4 ml of blood was drawn from the internal jugular vein at room entry (T0), end of surgery (T4), and the first day after surgery (T5) to measure the level of inflammatory factors and to analyze and compare the surgical-related conditions, changes in inflammatory immune factor levels, length of hospital stay, and postoperative pain between the two groups. The highest scores (VAS scale) and the ratio of secondary malignant effects were analyzedand compared between the two groups.Results:The MAP fluctuations of the experimental group at T2 and T3 were smaller, while the HR at the moment of T2 and T3 was significantly lower than that of the control group, and the comparative differences were statistically significant (P<0.05). The levels of immune inflammation and chemokines in the test group T5 were significantly better than those in this group T0 and T4; the levels of SDF-1, TNF-α, IL-6 and CRP indexes in the test group T4 and T5 were significantly lower than those in the control group, and the expression of CD3+, CD4+, CD4+/CD8+ and NK cells were significantly higher than those in the control group; the levels of CjvO2, Da-jvO2, CERO2 in the test group T4 were significantly lower than those in the control group; the number of postoperative hospitalization days and the highest postoperative pain score (VAS rating) in the test group were significantly lower than those in the control group, and there was no significant difference in the ratio of secondary malignant effects between the two groups after surgery.Conclusion: Dexmedetomidine can maintain circulatory stability, reduce inflammatory convergence due to surgical trauma, reduce inflammatory response, promote early recovery, reduce the number of days in hospital, and is suitable for widespread implementation.
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2022, Vol. 28 
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