关键词: 胆囊切除术, 腹腔镜, 加速康复外科, 右美托咪定

Abstract: Objective To explore the clinical significance of enhanced recovery after surgery (ERAS) in patients undergoing laparoscopic cholecystectomy (LC). 
Methods Eighty-five patients who underwent selective LC surgery in Hebei Petro China Central Hospital were selected, and divided into ERAS group (n=43) and control group (n=42) by random number table method. Both groups of patients were given demedetomidine-assisted anesthesia. In the meantime, ERAS group was given thermal insulation and team-based interventions based on the ERAS concept. The postoperative pain score, sleep quality, stress response and inflammatory factor levels, and anesthesia-related adverse reactions were compared between two groups. 
Results The scores of the visual analogue pain scale (VAS) in both groups at rest showed a trend of increasing initially and then decreasing, which were lower in the ERAS group than in the control group, and the VAS scores in both groups were consistently lower during cough, which were lower in the ERAS group than in the control group (P＜0.05). At 24 h after surgery, N1, N2, and arousal index in both groups were higher than those before surgery, while N3, rapid eye movement sleep (REM), and sleep efficiency were lower than those before surgery. N1 and arousal index in ERAS group were lower than those in control group, while REM and sleep efficiency values were higher than those in control group (P＜0.05). At 24 h after surgery, the levels of norepinephrine (NE), cortisol (Cor), interleukin-6 (IL-6), and C-reactive protein (CRP) in the two groups were higher than those before surgery, while the levels of NE and IL-6 in the ERAS group were lower than those in the control group (P＜0.05). The dosage of propofol in ERAS group was lower than that in the control group, the awakening time was shorter, and the number of PCA compression was lower than that in the control group (P＜0.05). The incidence of adverse anesthetic reactions in ERAS group was lower than that in control group (P＜0.05). 
Conclusion The application of ERAS in LC patients is conductive to reducing the postoperative pain level and inflammatory stress reaction and improving the sleep quality of patients. 

Key words: cholecystectomy, laparoscopic, enhanced recovery after surgery, demedetomidine