Purpose:To investigate efficacy of combined use of parecoxib and dexmedetomidine on postoperative pain and early cognitive dysfunction after laparoscopic cholecystectomy for elderly patients.Methods:The present prospective randomized controlled study included a total of 80 patients who underwent laparoscopic cholecystectomy surgery during January 2016 to November 2017 in our hospital. All patients were randomly divided into 4 groups, the parecoxib group, the dexmedetomidine group, the parecoxib and dexmedetomidine combined group, and the control group. Demographic data and clinical data were collected. Indexes of heart rate (HR), mean arterial pressure (MAP), levels of jugular venous oxygen saturation (SjvO2) and jugular venous oxygen pressure (PjvO2) were recorded at different time points before and during the surgery. The mini-mental state examination (MMSE) score, Ramsay score and Visual Analogue Score (VAS) were measured.Results:Levels of both SjvO2 and PjvO2 were significantly higher in parecoxib group, dexmedetomidine group and the combined group than the control group. Meanwhile, levels of both SjvO2 and PjvO2 in the combined group were the highest. VAS scores were significantly lower in the combined group than all other groups, and total patient controlled intravenous analgesia (PCIA) pressing times within 48 h after surgery were the lowest in the combined group. Both Ramsay and MMSE scores were the highest in the combined group compared with other groups, while were the lowest in the control group.Conclusion:The combined use of parecoxib and dexmedetomidine could reduce the postoperative pain and improve the postoperative sedation and cognitive conditions of patients after laparoscopic cholecystectomy.

A���������� �� ���������������-�������� ��������-A���������� �� ���������������-�������� ��������-��b��� �����h���� ��� ������y �������� w��h h�� ����������� ��� its influences on T-lymphocyte subsets in peripheral blood were assessed. Eighty-six patients undergoing intravertebral anesthesia in hip replacement were treated as group A, and one hundred patients undergoing intravertebral anesthesia combined with dexmedetomidine were treated as group B. Hemodynamic changes in both groups were compared 5 min b����� �����h���� (T0), ����������y ����� �k�� �������� (T1) and after surgery (T2). General operation conditions of patients in both groups were recorded. T-lymphocyte subsets, interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), visual analogue scale (VAS) pain scores and mini-mental state examination (MMSE) cognitive function changes before surgery and 24 h after surgery were compared between the groups, and the incidence of complications in both groups after 24 h was recorded. The recovery time of patients in group B was shorter than that of group A (P<0.05). Changes of systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate fluctuations in group B were lower than those in group A (P<0.05). At 24 h after surgery, VAS scores of group B were lower than those of group A (P<0.05); levels of IL-6 and TNF-α were lower than those of group A (P<0.05); CD3 + �����, CD4 + �����, CD8 + cells, and CD4/CD8 ratio were higher than those of group A (P<0.05), and MMSE score was higher than that of group A (P<0.05). The incidence of gastrointestinal reactions and postoperative cognitive dysfunction (POCD) in group B was lower than that in group A (P<0.05). In conclu-����, �������������� �� ��������������� ��� ����������y �h����� �h� �������y ���� �� ��������, ���b���z� �������������� hemodynamics of patients, protect immune function, and reduce postoperative pain and POCD occurrence during anes-�h���� �� h�� �����������.

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