{
  "abstract": "Background: Postoperative pulmonary complications (PPCs) ranging from 30% to 50% have been recognized as a major threat to postoperative recovery. Current conventional interventions cannot effectively reduce the occurrence of PPCs.\n\nObjective: In this study, we aimed to investigate the effects of multiple low-dose intranasal dexmedetomidine administration on PPCs in elderly patients.\n\nMethods: In this double-blind, randomized, controlled trial, elderly patients were randomly assigned at a 1:1 ratio to receive multiple low-dose intranasal dexmedetomidine administration (MD group) or normal saline nasal spray (NS group). The primary outcome was the incidence of PPCs within 7 days after surgery. Key secondary outcomes included the severity grading and classification of PPCs. Other secondary outcomes included serum interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) levels, Richards-Campbell sleep questionnaire (RCSQ) scores at predefined time points, and adverse reactions.\n\nResults: A total of 190 patients were screened, and 186 completed the study. The incidence of PPCs was significantly lower in the MD group than in the NS group (9.68% vs. 22.58%, P = 0.017), with a risk ratio (RR) of 2.333 [95% confidence interval (CI): 1.173–6.317], absolute risk reduction (ARR) of 12.90%, and number needed to treat (NNT) of 7.75. Sensitivity analyses using the per-protocol population (PP) dataset yielded consistent results, confirming the stability and reliability of the primary outcome. The distribution of severity grading of PPCs also differed significantly between the groups ( P = 0.036). After Bonferroni correction, the between-group difference in PPCs severity grading was not statistically significant (corrected P = 0.072). The distribution of pneumonia also differed significantly between the groups ( P = 0.029). There were significant group effects, time effects, and interaction effects for IL-6, TNF-α, and RCSQ in the two groups after surgery (all P < 0.05). No significant between-group differences were observed in drug-related adverse events.\n\nConclusion: Multiple low-dose intranasal dexmedetomidine administration significantly reduces the incidence of PPCs in elderly patients undergoing radical thoracoscopic lung-cancer resection with a favorable safety profile.\n\nClinical Trial Registration: https://www.chictr.org.cn/showproj.html?proj=243165 ; identifier ChiCTR2400090593.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Anesthesiology and Perioperative Medicine, Henan Provincial People’s Hospital , ,",
    "Department of Anesthesiology, People’s Hospital of Zhengzhou , ,"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 8,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Bing Li"
    },
    {
      "affs": [
        1
      ],
      "name": "Yao Liu"
    },
    {
      "affs": [
        0
      ],
      "name": "Xinmin Liu"
    },
    {
      "affs": [
        0
      ],
      "name": "Mengyan Han"
    },
    {
      "affs": [
        0
      ],
      "name": "Xing Meng"
    },
    {
      "affs": [
        0
      ],
      "name": "Mingyang Sun"
    },
    {
      "affs": [
        0
      ],
      "name": "Jiaqiang Zhang"
    },
    {
      "affs": [
        0
      ],
      "name": "Wei Zhang"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/9w07dycpa3yw2.bib",
  "cited_by": 0,
  "doi": "10.3389/fphar.2026.1914046",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13672550/?tool=EBI",
  "id": "9w07dycpa3yw2",
  "issns": [
    "1663-9812"
  ],
  "landing_url": "https://europepmc.org/article/PMC/PMC13672550",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2703|Anesthesia and Sedative Agents"
    ]
  ],
  "openalex": "W7216431199",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13672550/pdf/?tool=EBI",
  "pmcid": "PMC13672550",
  "pmid": null,
  "published": "2026-10-02",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/9w07dycpa3yw2.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:18:18Z",
      "native_id": "PMC:PMC13672550",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13672550"
    },
    {
      "first_seen": "2026-10-30T12:20:06Z",
      "native_id": "10.3389/fphar.2026.1914046",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fphar.2026.1914046/full"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2703|Anesthesia and Sedative Agents",
      "subfield": "surgery"
    }
  ],
  "title": "Effects of multiple low-dose intranasal dexmedetomidine administration on postoperative pulmonary complications in elderly patients undergoing thoracoscopic radical resection of lung cancer: a single-center randomized controlled trial",
  "title_text": "Effects of multiple low-dose intranasal dexmedetomidine administration on postoperative pulmonary complications in elderly patients undergoing thoracoscopic radical resection of lung cancer: a single-center randomized controlled trial",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:06Z",
  "url": "https://research.draconitic.com/paper/9w07dycpa3yw2",
  "venue": "Frontiers in pharmacology",
  "versions": []
}