Effects of dexmedetomidine nasal spray on perioperative anxiety and quality of postoperative recovery in patients undergoing modified radical mastectomy for breast cancer.

BACKGROUND

Dexmedetomidine possesses sedative, analgesic, and anxiolytic properties, but there is still a lack of sufficient clinical data regarding its preoperative intranasal administration. The present study was designed to evaluate whether preoperative intranasal dexmedetomidine spray could alleviate perioperative anxiety and improve postoperative recovery quality in patients with breast cancer undergoing modified radical mastectomy.

METHODS

Ninety patients undergoing modified radical mastectomy were randomly assigned to either the dexmedetomidine group (Group D, n = 45) or the control group (Group C, n = 45). Group D received preoperative intranasal dexmedetomidine spray, whereas Group C received an equal volume of intranasal saline. The primary outcome was the Perioperative Anxiety Scale-7 (PAS-7) score at 30 min after administration. Secondary outcomes included Quality of Recovery-15 (QoR-15) scores at 24 and 48 h after surgery, Asensius Insomnia Scale (AIS) scores during the first and second postoperative nights, perioperative vital signs and BIS values, intraoperative anesthetic consumption, vasoactive drug use, emergence time, and baseline characteristics.

RESULTS

The PAS-7 score at 30 min after administration was significantly lower in Group D than in Group C (9.71 ± 2.07 vs. 12.44 ± 1.98, P < 0.001). QoR-15 scores at both 24 and 48 h postoperatively were significantly higher in Group D than in Group C (120.11 ± 6.90 vs. 111.27 ± 7.14, P < 0.001; 127.04 ± 6.39 vs. 123.20 ± 6.37, P = 0.005). No significant between-group differences were observed in AIS scores, intraoperative hemodynamic variables at most time points, anesthetic consumption, or vasoactive drug use. Time to emergence was significantly longer in Group D than in Group C (8.36 ± 2.79 vs. 6.36 ± 2.83, P = 0.001). Baseline characteristics were comparable between the two groups.

CONCLUSION

Preoperative intranasal dexmedetomidine spray effectively alleviated preoperative anxiety and improved early postoperative quality of recovery in patients undergoing modified radical mastectomy, without significant adverse effects on intraoperative hemodynamics, although time to emergence was prolonged.