Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 12 2 2026 02 22 118 125 Hendrikus Gede Surya Adhi Putra Department of Anesthesiology and Intensive Care, Giri Emas General Hospital, Singaraja, Indonesia. Made Wiryana Department of Anesthesiology and Intensive Care, Udayana University, Denpasar, Indonesia. Tjokorda Gde Senapathi Department of Anesthesiology and Intensive Care, Udayana University, Denpasar, Indonesia. I Gusti Ngurah Mahaalit Aribawa Department of Anesthesiology and Intensive Care, Udayana University, Denpasar, Indonesia. I Made Gede Widnyana Department of Anesthesiology and Intensive Care, Udayana University, Denpasar, Indonesia. Dewa Ayu Mas Shintya Dewi Department of Anesthesiology and Intensive Care, Udayana University, Denpasar, Indonesia. André A.J. Zundert Department of Anesthesiology, University of Queensland, Brisbane, Australia. Christopher Ryalino Department of Anesthesiology and Intensive Care, Udayana University, Denpasar, Indonesia. & Department of Anesthesiology, University Medical Center Groningen, Groningen, Netherlands. 2025 05 16 2025 05 30 Background: Postoperative cognitive dysfunction (POCD) is a major concern in anesthesia, leading to increased morbidity and longer hospital stays. Our study aimed to evaluate the efficacy of target-controlled infusion (TCI) dexmedetomidine in reducing the incidence of POCD following laparotomy surgery. Methods: A single-blinded, randomized controlled trial involving 107 patients aged >18 years old undergoing laparotomy surgery was conducted. Patients were randomly assigned to 54 patients in Group D (TCI dexmedetomidine with a target plasma of 1 ng/ml) and 53 patients in Group I (sevoflurane at 0.8% concentration). Results: Our study showed subjects whose anesthesia was maintained by TCI dexmedetomidine had a lower chance of developing POCD (p=0.043) and experienced less pain at 12 hours (p=0.049) and 24 hours (p=0.049) in the postoperative period, compared to the control group. There were no significant differences between both groups in intraoperative MAP (p=0.290) and HR (p=0.453). Conclusion: Maintaining anesthesia using Conox®-guided TCI dexmedetomidine reduces the incidence of POCD and postoperative pain in laparotomy patients who underwent general anesthesia. https://aacc.tums.ac.ir/index.php/aacc/article/view/1288