Effect of a combination of dexmedetomidine and either isoflurane or sevoflurane on elderly patients undergoing radical resection for gallbladder cancer

Abstract

Purpose: To determine the efficacy of dexmedetomidine (DEX) plus either isoflurane or sevoflurane, in elderly gallbladder cancer patients given radical resection. Methods: A total of 278 elderly patients assessed for eligibility and scheduled for radical gallbladder cancer resection in Hunan Cancer Hospital, Changsha, China were recruited. They were randomly assigned at a ratio of 1:1 to receive either DEX plus isoflurane or DEX plus sevoflurane. These two groups were compared with respect to immune functions (CD3+, CD 4+, CD 8+, and CD4+/CD8+ T cells); inflammatory factors, and cognitive function scores. Results: The sevoflurane cohort had higher immune function indices, lower levels of inflammatory cytokines, and better oxidative stress indices, than the isoflurane cohort (p < 0.05). Postoperatively, cognitive function scores in both cohorts were reduced. At postoperative 12 and 24 h, sevoflurane cohort had higher scores than the isoflurane group. Sevoflurane was more effective in stabilizing hemodynamic indices than isoflurane. Conclusion: DEX plus sevoflurane produces more significant improvements in the cognitive function of elderly patients undergoing radical resection for gallbladder cancer, with milder immune function impairment, milder inflammatory response, and lower degree of oxidative stress, than isoflurane.