Published online Feb 27, 2026. doi: 10.4240/wjgs.v18.i2.113525
Revised: October 24, 2025
Accepted: December 8, 2025
Published online: February 27, 2026
Processing time: 166 Days and 22.8 Hours
Elderly patients undergoing laparoscopic cholecystectomy (LC) are at increased risk for postoperative complications.
To investigate the impact of dexmedetomidine (DEX) preconditioning on post
A retrospective analysis was conducted involving elderly patients (aged ≥ 60 years), who underwent LC between May 2023 and April 2024. Patients were categorized into two groups based on DEX administration protocols: (1) DEX preconditioning anesthesia (DEX-PA) group; and (2) DEX conventional anesthesia group. Postoperative assessments included pain (Visual Analog Scale), sedation (Ramsay Sedation Scale), oxidative stress and inflammation at 6 hours, recovery from anesthesia, gastrointestinal function recovery, cognitive scores (mini-mental state examination), and incidence of adverse events.
Among 182 patients (DEX-PA = 87, DEX conventional anesthesia = 95), the DEX-PA group showed significantly lower Visual Analog Scale scores (6 hours: 3.86 ± 1.23 vs 4.46 ± 1.38, P = 0.002), reduced oxidative stress (malondialdehyde: 3.17 ± 0.56 μmol/L vs 3.39 ± 0.61 μmol/L, P = 0.013) and inflammation (C-reactive protein: 5.24 ± 1.35 mg/L vs 5.77 ± 1.62 mg/L, P = 0.018), shorter awakening times (14.87 ± 2.67 minutes vs 15.75 ± 2.82 minutes, P = 0.032), shorter stays in the post-anesthesia care unit (58.24 ± 10.85 minutes vs 62.38 ± 12.47 minutes, P = 0.018), accelerated gastrointestinal recovery (time to first defecation: 36.82 ± 7.63 hours vs 39.95 ± 8.24 hours, P = 0.009), better cognitive performance at 6 hours (25.53 ± 1.87 vs 24.72 ± 2.15, P = 0.008), and fewer adverse events (agitation: 4.60% vs 14.74%, P = 0.022).
DEX preconditioning prior to anesthesia induction significantly enhances postoperative analgesia, reduces oxi
Core Tip: This study demonstrates that administering a loading dose of dexmedetomidine (DEX) as a pre-treatment strategy before anesthesia induction offers notable benefits for elderly patients undergoing laparoscopic cholecystectomy. Compared to the routine use of DEX solely during surgery, pre-treatment with DEX enhanced postoperative analgesia, reduced oxidative stress and inflammation, accelerated recovery of gastrointestinal and cognitive functions, and lowered the incidence of agitation without increasing intraoperative hemodynamic risks. These findings highlight the critical importance of the timing of DEX administration and suggest a promising optimized anesthesia approach to promote recovery in elderly surgical patients.