Objective To investigate the value of dexmedetomidine combined with nalbuphine in gynecological senile patients undergoing laparoscopic surgery.

Methods The elderly patients who underwent laparoscopic surgery were divided into control group (n = 55) and the combined group (n = 55). The combined group was given dexmedetomidine hydrochloride and nalbuphine hydrochloride, while the control group was given the same amount of normal saline and nalbuphine hydrochloride simultaneously. The heart rate (HR), mean arterial pressure (MAP), score of restlessness during recovery, Mini-Mental State Examination (MMSE) score, Ramsay score, montreal cognitive assessment (MoCA), cellular immune function and compare the incidence of postoperative adverse reactions between two groups of patients.

Results At the end of the operation (T2), the HR of the combined group was significantly lower than that of the control group, and the MAP of the combined group was significantly lower than that of the control group immediately after tracheal intubation (T1) and T2 (P ＜ 0.05); at 24 h and 72 h after operation, the MMSE, MoCA score of both groups were lower than those before operation, and the combined group was higher than that of the control group (P ＜ 0.05); at 72 hours after operation, the MMSE, MoCA score in both groups was higher than at 24 hours after operation (P ＜ 0.05); the incidence of restlessness in the combined group was 23.63%, which was greatly lower than that in the control group (54.54%) (P ＜ 0.05); at all postoperative time points, the Ramsay score of the combined group was significantly higher than that of the control group (P ＜ 0.05). There were significant changes in CD3+, CD4+, CD8+, CD4+/CD8+ and NK cells between the two groups at 24 h and 72 h after operation, and the improvement of the above indexes in the combined group was better than that in the control group at 24 h and 72 h after operation (P ＜ 0.05). The total incidence of adverse reactions in the combined group and the control group were 12.73% and 18.18%, respectively, with no statistical difference (P ＞ 0.05).

Conclusion Dexmedetomidine combined with nalbuphine can achieve satisfactory sedation effect in elderly patients undergoing gynecological laparoscopic surgery, effectively inhibit the intraoperative stress response of patients, and has a positive effect on early postoperative cognitive function, restlessness during recovery and immune function of patients, with high safety.