Intraoperative Dexmedetomidine Improves the Quality of Recovery and Postoperative Pulmonary Function in Patients Undergoing Video-assisted Thoracoscopic Surgery: A CONSORT-Prospective, Randomized, Controlled Trial

Abstract

Video-assistedthoracoscopicsurgery(VATS) has been known to be a stressful event forpatients, anddexmedetomidineis known to attenuatesurgery-induced sympathetic responses and potentiate analgesia in perioperative periods. The present was designed to evaluate the effects ofintraoperativedexmedetomidineadministration on thequalityofrecovery(QoR) andpulmonaryfunctionafter VATS.Patientswith lung cancerundergoingVATS wererandomizedto Dex group (loading of 1.0 μg/kg for 20 minutes before the termination ofsurgery, n = 50) or Control group (comparable volume of normal saline, n = 50). The QoR-40 questionnaire assessespostoperativerecoveryand validates the overall surgical and general anesthesia outcomes. The QoR-40 scores, forced expiratory volume for 1 second (FEV1) onpostoperativeday (POD) 1 and 2, and emergence agitation were evaluated. The global QoR-40 score (162.3 ± 17.8 vs 153.3 ± 18.7, P = 0.016 on POD 1; 174.3 ± 16.0 vs 166.8 ± 16.7, P = 0.028 on POD 2) and FEV1 (2.1 ± 0.4 vs 1.9 ± 0.5 L, P = 0.034 on POD 1; 2.2 ± 0.5 vs 2.0 ± 0.4 L, P = 0.030 on POD 2) were significantly higher in the Dex group compared with the Control group on POD1 and POD 2. The score of emergence agitation was lower in the Dex group compared with the Control group (3 [2-5] vs 5 [3-7], P < 0.001). The number ofpatientsindicating severe emergence agitation was shorter in the Dex group than Control group (0 [0%] vs 7 [14%], P = 0.048). The length of hospital stay was significantly shorter (6.7 [3-9] vs 8.4 [4-9] days, P = 0.045) in the Dex group compared with the Control group.Intraoperativedexmedetomidineadministration improved QoR,postoperativepulmonaryfunction, and emergence agitation inpatientsundergoingVATS. Consequently,intraoperativedexmedetomidineadministration could improvepostoperativeoutcomes and reduced the length of hospital stay inpatientsundergoingVATS.