Impact of dexmedetomidine preconditioning on analgesic and postoperative recovery in elderly patients undergoing laparoscopic cholecystectomy

doi:10.4240/wjgs.v18.i2.113525

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Feb 27, 2026 (publication date) through Feb 26, 2026

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World Journal of Gastrointestinal Surgery

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1948-9366

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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©Author(s) (or their employer(s)) 2026. No commercial re-use. See Permissions. Published by Baishideng Publishing Group Inc.

World J Gastrointest Surg. Feb 27, 2026; 18(2): 113525
Published online Feb 27, 2026. doi: 10.4240/wjgs.v18.i2.113525

Table 1 Comparison of demographic characteristics between two groups, n (%)/mean ± SD

Parameter	DEX conventional anesthesia group (n = 95)	DEX preconditioning anesthesia group (n = 87)	t/χ²	P value
Age (years)	71.38 ± 5.26	71.41 ± 5.42	0.031	0.975
Gender			0.316	0.574
Male	52 (54.74)	44 (50.57)
Female	43 (45.26)	43 (49.43)
Body mass index (kg/m²)	24.37 ± 1.27	24.43 ± 1.32	0.337	0.736
Educational background			0.356	0.837
Junior high or below	38 (40.00)	32 (36.78)
High school	30 (31.58)	31 (35.63)
Tertiary and above	27 (28.42)	24 (27.59)
Smoking history	22 (23.16)	20 (22.99)	0.001	0.978
Drinking history	18 (18.95)	15 (17.24)	0.089	0.765
Complication
Hypertension	21 (22.11)	23 (26.44)	0.465	0.495
Diabetes	10 (10.53)	12 (13.79)	0.456	0.499
Coronary heart disease	11 (11.58)	14 (16.09)	0.781	0.377
Hyperlipidemia	17 (17.89)	19 (21.84)	0.445	0.505
American Society of Anesthesiologists grading			0.173	0.677
I grade	65 (68.42)	57 (65.52)
II grade	30 (31.58)	30 (34.48)
Disease type			2.854	0.091
Gallstone	81 (85.26)	81 (93.10)
Gallbladder polyps	14 (14.74)	6 (6.90)

DEX: Dexmedetomidine.

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Table 2 Comparison of surgery features between two groups, n (%)/mean ± SD

Parameter	DEX conventional anesthesia group (n = 95)	DEX preconditioning anesthesia group (n = 87)	t/χ²	P value
Operative duration (minutes)	82.86 ± 12.43	82.25 ± 12.27	0.334	0.739
Anesthesia duration (minutes)	89.62 ± 13.84	89.84 ± 13.43	0.107	0.915
Intraoperative bleeding volume (mL)	14.44 ± 1.92	14.86 ± 2.24	1.351	0.178
Fluid replacement volume (mL)	746.25 ± 48.43	758.24 ± 50.91	1.628	0.105
Dose of anesthesia inducing drugs
Midazolam (mg)	2.12 ± 0.35	2.08 ± 0.32	0.711	0.478
Propofol (mg)	135.52 ± 20.25	132.75 ± 19.83	0.932	0.353
Sufentanil (μg)	24.38 ± 3.72	23.92 ± 3.69	0.847	0.398
Atracurium (mg)	12.25 ± 1.87	12.16 ± 1.78	0.344	0.731
Dose of anesthesia maintenance drugs
Propofol (mg)	452.38 ± 67.21	443.92 ± 65.84	0.856	0.393
Remifentanil (μg)	1286.54 ± 214.36	1262.47 ± 208.92	0.766	0.445
DEX (μg)	42.18 ± 6.32	41.75 ± 6.18	0.459	0.647
Times of atracurium is added	25 (26.32)	20 (22.99)	0.270	0.603

DEX: Dexmedetomidine.

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Table 3 Comparison of postoperative sedation scores (points) between two groups, mean ± SD

Parameter	DEX conventional anesthesia group (n = 95)	DEX preconditioning anesthesia group (n = 87)	t value	P value
Postoperative 6 hours	4.23 ± 0.47	4.26 ± 0.35	0.440	0.660
Postoperative 12 hours	3.97 ± 0.39	4.01 ± 0.32	0.847	0.398
Postoperative 24 hours	3.52 ± 0.45	3.66 ± 0.68	1.652	0.101
Postoperative 48 hours	3.07 ± 0.26	3.14 ± 0.33	1.470	0.143

DEX: Dexmedetomidine.

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Table 4 Comparison of oxidative stress and stress response markers between two groups, mean ± SD

Parameter	DEX conventional anesthesia group (n = 95)	DEX preconditioning anesthesia group (n = 87)	t value	P value
Oxidative stress markers
Malondialdehyde (μmol/L)
Preoperative	2.31 ± 0.43	2.23 ± 0.35	1.465	0.145
Postoperative 6 hours	3.39 ± 0.61	3.17 ± 0.56	2.520	0.013
Superoxide dismutase (U/mL)
Preoperative	73.41 ± 7.85	72.04 ± 7.62	1.193	0.234
Postoperative 6 hours	88.32 ± 8.46	91.14 ± 6.79	2.494	0.014
Total antioxidant capacity (mmol ascorbic acid Eq/L)
Preoperative	16.23 ± 2.26	16.79 ± 2.95	1.420	0.157
Postoperative 6 hours	13.59 ± 2.33	14.47 ± 2.61	2.391	0.018
Stress response markers
Cortisol (µg/dL)
Preoperative	12.62 ± 1.47	12.94 ± 1.08	1.663	0.098
Postoperative 6 hours	15.02 ± 2.35	14.32 ± 2.01	2.164	0.032
Tumor necrosis factor-alpha (pg/mL)
Preoperative	1.83 ± 0.31	1.86 ± 0.37	0.577	0.565
Postoperative 6 hours	3.47 ± 0.98	3.15 ± 0.76	2.429	0.016
C-reactive protein (mg/L)
Preoperative	1.54 ± 0.32	1.49 ± 0.43	0.874	0.384
Postoperative 6 hours	5.77 ± 1.62	5.24 ± 1.35	2.388	0.018

DEX: Dexmedetomidine.

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Table 5 Comparison of the recovery of anesthesia and gastrointestinal function recovery between two groups, mean ± SD

Parameter	DEX conventional anesthesia group (n = 95)	DEX preconditioning anesthesia group (n = 87)	t value	P value
Anesthesia recovery
Awakening time (minutes)	15.75 ± 2.82	14.87 ± 2.67	2.164	0.032
Extubating time (minutes)	17.44 ± 3.51	17.46 ± 3.63	0.039	0.969
Duration of stay in the anesthesia care unit (minutes)	62.38 ± 12.47	58.24 ± 10.85	2.377	0.018
Gastrointestinal function recovery
Bowel sounds recovery time (hours)	7.52 ± 1.85	6.73 ± 1.42	3.259	0.001
First exhaust time (hours)	20.47 ± 4.32	18.63 ± 3.75	3.052	0.003
First defecation time (hours)	39.95 ± 8.24	36.82 ± 7.63	2.653	0.009

DEX: Dexmedetomidine.

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Table 6 Comparison of cognitive function scores between two groups (points), mean ± SD

Parameter	DEX conventional anesthesia group (n = 95)	DEX preconditioning anesthesia group (n = 87)	t value	P value
Preoperative	27.35 ± 1.24	27.42 ± 1.18	0.398	0.691
Postoperative 6 hours	24.72 ± 2.15	25.53 ± 1.87	2.683	0.008
Postoperative 12 hours	25.63 ± 1.96	26.24 ± 1.65	2.254	0.025
Postoperative 24 hours	26.85 ± 1.47	26.92 ± 1.32	0.296	0.767
Postoperative 48 hours	26.93 ± 1.25	27.15 ± 1.18	1.236	0.218

DEX: Dexmedetomidine.

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Citation: Chen M, Chen FC, Pan Q, Liu ZH. Impact of dexmedetomidine preconditioning on analgesic and postoperative recovery in elderly patients undergoing laparoscopic cholecystectomy. World J Gastrointest Surg 2026; 18(2): 113525
URL: https://www.wjgnet.com/1948-9366/full/v18/i2/113525.htm
DOI: https://dx.doi.org/10.4240/wjgs.v18.i2.113525