Objective To investigate the effect of dexmedetomidine combined with epidural anesthesia on Ramsay sedation score

mean arterial pressure（MAP） and heart rate（HR） in elderly patients underwent laparoscopic cholecystectomy to provide reference for clinical treatment. Methods A total of 126 elderly patients who underwent laparoscopic cholecystectomy in Luanchuan People’s Hospital from February 2019 to July 2021 were selected as the study subjects. The patients were assigned to the experimental group and the control group by the random number table

with 63 cases in each group. Patients in the experimental group received general anesthesia with dexmedetomidine combined with epidural anesthesia

and patients in the control group were treated with epidural anesthesia. The Ramsay sedation score

MAP

and HR were compared between the 2 groups at five time points: before administration（T0）

5 min after administration（T1）

10 min after administration（T2）

during intraoperative gallbladder traction（T3）

and at the end of surgery（T4）. Visual analogue scale（VAS） scores were compared between the 2 groups at 8 h

16 h

20 h

and 24 h after surgery. Postoperative adverse reactions were compared between the two groups. Results There was no significant difference in Ramsay sedation score

MAP

and HR at T0 between the two groups（P>0.05）. Ramsay scores at T1

T2

T3

and T4 were significantly higher than T0 in the 2 groups（P<0.05）. MAP and HR at T1

T2

T3

and T4 were significantly lower than T0 in the 2 groups（P<0.05）. There were significant differences in Ramsay sedation score

MAP

and HR at T1

T2

T3

and T4 between the 2 groups（P<0.05）. The VAS scores at 8 h

16 h

and 20 h after operation in the experimental group were significantly lower than those in the control group（P<0.05）. There was no significant difference in VAS score at 24 h after operation between the two groups（P>0.05）. No adverse reactions were observed in the 2 groups. Conclusion Dexmedetomidine in combination with epidural anesthesia has a satisfactory anesthetic effect in elderly patients who underwent laparoscopic cholecystectomy and has marked effects in stabilizing intraoperative hemodynamic parameters and reducing postoperative pain. These benefits hold promise for a wider application of this procedure in clinical practice.