Trial reportBMC anesthesiology2026
Timing of a single dexmedetomidine bolus to attenuate remifentanil-induced hyperalgesia after thyroidectomy: a randomized controlled trial.
Trial report in BMC anesthesiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors.
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Abstract
backgroundRemifentanil-induced hyperalgesia (RIH) is a frequent postoperative complication. Dexmedetomidine can attenuate RIH, but whether the effect depends on the timing of administration remains unclear. The study compared two clinically relevant timings of a single dexmedetomidine bolus in patients undergoing thyroidectomy.
methodsA total of 118 patients were randomized into three groups: Group I (dexmedetomidine before anesthesia induction), Group R (dexmedetomidine at skin closure), and Group C (control). The primary outcome was the mechanical pain threshold measured on the dominant forearm at 30 min postoperatively. Secondary outcomes included peri-incisional pain threshold, pain intensity, QoR-15 recovery score, hemodynamic stability, and adverse events.
resultsMechanical pain thresholds at 30 min postoperatively were significantly higher in Groups I and R than in Group C. Only Group R showed a lower incidence of peri-incisional hyperalgesia at 24 h (P = 0.004). Resting pain scores, rescue analgesic use, and QoR-15 total scores were comparable among groups. Compared with Group I, Group R showed a more favorable intraoperative hemodynamic profile and a lower ephedrine requirement, but longer times to eye-opening and extubation.
conclusionsIn adults aged 18-65 years undergoing thyroidectomy, a single dexmedetomidine bolus administered at skin closure was associated with improved quantitative sensory testing-derived measures of mechanical hyperalgesia, including a lower incidence of peri-incisional hyperalgesia at 24 h. However, these sensory-threshold findings were not accompanied by lower resting pain scores, reduced rescue analgesic use, or improved QoR-15 recovery scores. Therefore, the results should be interpreted primarily as evidence of an antihyperalgesic effect measured by mechanical sensory testing rather than as proof of a clinically established analgesic benefit. Further studies incorporating movement-evoked pain and broader patient populations are needed to clarify the clinical relevance of these findings.
trial registrationChinese Clinical Trial Registry, ChiCTR2300071038, registered 30 April 2023.
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