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Peer-reviewedCC BYFrontiers in pharmacology

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

  • Bing Li1
  • Yao Liu2
  • Xinmin Liu1
  • Mengyan Han1
  • Xing Meng1
  • Mingyang Sun1
  • Jiaqiang Zhang1
  • Wei Zhang1
  1. 1Department of Anesthesiology and Perioperative Medicine, Henan Provincial People’s Hospital , ,
  2. 2Department of Anesthesiology, People’s Hospital of Zhengzhou , ,
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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.

Objective: In this study, we aimed to investigate the effects of multiple low-dose intranasal dexmedetomidine administration on PPCs in elderly patients.

Methods: 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.

Results: 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.

Conclusion: 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.

Clinical Trial Registration: https://www.chictr.org.cn/showproj.html?proj=243165 ; identifier ChiCTR2400090593.

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Cite

BibTeXRIS
BibTeX
@article{li2026effects,
  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}},
  author = {Bing Li and Yao Liu and Xinmin Liu and Mengyan Han and Xing Meng and Mingyang Sun and Jiaqiang Zhang and Wei Zhang},
  journal = {Frontiers in pharmacology},
  year = {2026},
  month = oct,
  doi = {10.3389/fphar.2026.1914046},
  url = {https://europepmc.org/article/PMC/PMC13672550},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - 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
AU  - Bing Li
AU  - Yao Liu
AU  - Xinmin Liu
AU  - Mengyan Han
AU  - Xing Meng
AU  - Mingyang Sun
AU  - Jiaqiang Zhang
AU  - Wei Zhang
PY  - 2026
DA  - 2026/10/02
JO  - Frontiers in pharmacology
DO  - 10.3389/fphar.2026.1914046
UR  - https://europepmc.org/article/PMC/PMC13672550
AB  - 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.  Objective: In this study, we aimed to investigate the effects of multiple low-dose intranasal dexmedetomidine administration on PPCs in elderly patients.  Methods: 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.  Results: 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.  Conclusion: 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.  Clinical Trial Registration: https://www.chictr.org.cn/showproj.html?proj=243165 ; identifier ChiCTR2400090593.
SN  - 1663-9812
ER  -