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

Video-assisted thoracoscopic surgery (VATS) has been known to be a stressful event for patients, and dexmedetomidine is known to attenuate surgery-induced sympathetic responses and potentiate analgesia in perioperative periods. The present was designed to evaluate the effects of intraoperative dexmedetomidine administration on the quality of recovery (QoR) and pulmonary function after VATS. Patients with lung cancer undergoing VATS were randomized to Dex group (loading of 1.0 mu g/kg for 20 minutes before the termination of surgery, n=50) or Control group (comparable volume of normal saline, n=50). The QoR-40 questionnaire assesses postoperative recovery and validates the overall surgical and general anesthesia outcomes. The QoR-40 scores, forced expiratory volume for 1 second (FEV1) on postoperative day (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 of patients indicating 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. Intraoperative dexmedetomidine administration improved QoR, postoperative pulmonary function, and emergence agitation in patients undergoing VATS. Consequently, intraoperative dexmedetomidine administration could improve postoperative outcomes and reduced the length of hospital stay in patients undergoing VATS.