Effects of Different Doses of Dexmedetomidine on Perioperative Stress Response and Postoperative Recovery in Elderly Patients.

PURPOSE: The management of surgical anesthesia in elderly patients presents significant challenges due to age-related physiological decline and the high prevalence of chronic diseases. This study aimed to optimize anesthesia management by exploring the dose-dependent effects of dexmedetomidine on perioperative stability and postoperative recovery.

DESIGN

This was a retrospective, controlled study comparing three anesthesia strategies involving varying doses of dexmedetomidine or placebo in elderly surgical patients.

METHODS

A total of 148 patients who underwent elective abdominal surgery between January 2024 and April 2024 were included. Patients were divided into the control group (NS group), dexmedetomidine low-dose group (DL group), and high-dose group (DH group). Before anesthesia induction, patients in the DL and DH groups received dexmedetomidine at different doses, while those in the NS group received intravenous saline. Anesthesia was induced with sufentanil, etomidate, and rocuronium and maintained with sevoflurane combined with remifentanil. Hemadynamic parameters, stress-related biomarkers, and postoperative recovery indicators were collected and analyzed.

FINDINGS: The hemodynamic and stress response curves in the DL and DH groups were more stable compared to the NS group. Serum cortisol and adrenocorticotropic hormone in the DH group were lower than in the NS and DL groups. The levels of aldosterone and C-reactive protein in the DL and DH group were slightly higher than in the NS group at baseline (T1), showed similar levels during anesthesia induction (T2), and were lower than in the NS group 5 minutes after tracheal intubation (T3).

CONCLUSIONS

Dexmedetomidine administration during the perioperative period contributes to maintaining intraoperative hemodynamic stability, reducing surgical stress responses, and enhancing postoperative recovery in elderly patients. Additionally, higher doses of dexmedetomidine were associated with improved postoperative pain relief and cognitive function compared to lower doses and the control group.