Evidence map›Paper›PMID 42897486›Full record

Trial reportBMC anesthesiology2026

Dexmedetomidine-based opioid-sparing anesthesia in video-assisted thoracoscopic surgery: a randomized controlled trial.

Kai-Wei Hsieh, Chun-Hsien Wen, Chen-Hsiu Chen

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in BMC anesthesiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05431322 (Impact of Dexmedetomidine as an Opioid-Sparing Strategy in Thoracoscopic Surgery), which is not on this map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05431322 nacompletednot on this map

Impact of Dexmedetomidine as an Opioid-Sparing Strategy in Thoracoscopic Surgery: A Randomised Controlled Trial

TypeinterventionalSponsorKaohsiung Veterans General Hospital.Ran2022 to 2023Enrolled73ConditionsOpioid Use, Postoperative PainArmsDexmedetomidine
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Kai-Wei HsiehDepartment of Anesthesiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
Chun-Hsien WenDepartment of Anesthesiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
Chen-Hsiu ChenDepartment of Anesthesiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan. chschen@vghks.gov.tw.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDexmedetomidine has increasingly been incorporated into opioid-sparing anesthetic strategies during video-assisted thoracoscopic surgery (VATS) because of its analgesic properties and minimal respiratory depression. However, dexmedetomidine remains associated with dose-related hemodynamic adverse effects, particularly bradycardia and hypotension. We evaluated whether a reduced-dose dexmedetomidine regimen decreases intraoperative opioid requirements while maintaining acceptable hemodynamic safety during VATS.

methodsIn this prospective randomized controlled trial, 68 patients undergoing VATS were randomly assigned to either a dexmedetomidine group or a control group (34 patients each). The dexmedetomidine group received a loading dose of 0.5 µg/kg followed by continuous infusion at 0.5 µg/kg/h during surgery. The control group received conventional fentanyl-based anesthesia. The primary outcome was maintenance-phase rescue fentanyl consumption. Secondary outcomes included postoperative pain scores, postoperative nausea and vomiting (PONV), postoperative respiratory complications, and perioperative safety outcomes.

resultsMaintenance-phase rescue fentanyl consumption was significantly lower in the dexmedetomidine group than in the control group (18.7 vs. 33.2 µg, P = 0.009). Postoperative pain scores, rescue analgesic requirements, PONV, and respiratory complications were comparable between groups. However, the dexmedetomidine group demonstrated a higher incidence of intraoperative bradycardia (23.5% vs. 0%, P = 0.005) and postoperative hypotension during PACU stay (23.5% vs. 2.9%, P = 0.027). These hemodynamic events were transient and responsive to pharmacologic intervention.

conclusionsDexmedetomidine-based opioid-sparing anesthesia reduced maintenance-phase rescue fentanyl administration during VATS. However, the reduction was modest, was not associated with clear postoperative benefits, and was accompanied by increased bradycardia and hypotension.

trial registrationClinicalTrials.gov (NCT05431322), registered on 14 June 2022. Available at https://clinicaltrials.gov/study/NCT05431322 .

Indexed as

Analgesics, Non-NarcoticAnalgesics, OpioidDexmedetomidineThoracic Surgery, Video-AssistedAgedBradycardiaFemaleFentanylHumansMaleMiddle AgedPostoperative Nausea and VomitingPostoperative PainProspective StudiesAnalgesics, Non-NarcoticAnalgesics, OpioidDexmedetomidineFentanylBradycardiaDexmedetomidineLung cancerOpioid-sparing anesthesiaVATS

Identifiers

PMID42897486

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.