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.

Authors

Bing Li, Yao Liu, Xinmin Liu, Mengyan Han, Xing Meng, Mingyang Sun, Jiaqiang Zhang, Wei Zhang

Published in

Frontiers in pharmacology. Volume 17. Pages 1914046. Epub Oct 02, 2026.

Abstract

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.
In this study, we aimed to investigate the effects of multiple low-dose intranasal dexmedetomidine administration on PPCs in elderly patients.
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.
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.
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.
https://www.chictr.org.cn/showproj.html?proj=243165; identifier ChiCTR2400090593.

PMID:
42890876
Bibliographic data and abstract were imported from PubMed on 18 Oct 2026.

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