{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T20:15:54Z","timestamp":1793218554276,"version":"4.5.0"},"reference-count":47,"publisher":"American Medical Association (AMA)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"<jats:sec><jats:title>Importance<\/jats:title><jats:p>Posttraumatic stress disorder (PTSD) is common in people who have experienced trauma, especially those hospitalized for surgery. Dexmedetomidine may reduce or reverse the early consolidation and formation of conditioned fear memory and prevent the occurrence of postoperative PTSD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the effects of intraoperative and postoperative low-dose intravenous pumping dexmedetomidine on PTSD among patients with trauma undergoing emergency surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>This double-blind, randomized clinical trial was conducted from January 22 to October 20, 2022, with follow-up 1 month postoperatively, in patients with trauma undergoing emergency surgery at 4 hospital centers in Jiangsu Province, China. A total of 477 participants were screened. The observers were blinded to patient groupings, particularly for subjective measurements.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interventions<\/jats:title><jats:p>Dexmedetomidine or placebo (normal saline) was administered at a maintenance dose of 0.1 \u03bcg\/kg hourly from the start of anesthesia until the end of surgery and at the same rate after surgery from 9 <jats:sc>pm<\/jats:sc> to 7 <jats:sc>am<\/jats:sc> on days 1 to 3.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>The primary outcome was the difference in the incidence of PTSD 1 month after surgery in the 2 groups. This outcome was assessed with the Clinician-Administered PTSD Scale for <jats:italic>Diagnostic and Statistical Manual of Mental Disorders<\/jats:italic> (Fifth Edition) (CAPS-5). The secondary outcomes were the pain score within 48 hours and 1 month postoperatively; incidence of postoperative delirium, nausea, and pruritus; subjective sleep quality; anxiety; and occurrence of adverse events.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 310 patients (154 in the normal saline group and 156 in the dexmedetomidine group) were included in the modified intention-to-treat analysis (mean [SD] age, 40.2 [10.3] years; 179 men [57.7%]). The incidence of PTSD was significantly lower in the dexmedetomidine group than in the control group 1 month postoperatively (14.1% vs 24.0%; <jats:italic>P<\/jats:italic>\u2009=\u2009.03). The participants in the dexmedetomidine group had a significantly lower CAPS-5 score than those in the control group (17.3 [5.3] vs 18.9 [6.6]; mean difference, 1.65; 95% CI, 0.31-2.99; <jats:italic>P<\/jats:italic>\u2009=\u2009.02). After adjusting for potential confounders, the patients in the dexmedetomidine group were less likely to develop PTSD than those in the control group 1 month postoperatively (adjusted odds ratio, 0.51; 95% CI, 0.27-0.94; <jats:italic>P<\/jats:italic>\u2009=\u2009.03).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions and Relevance<\/jats:title><jats:p>In this randomized clinical trial, the administration of intraoperative and postoperative dexmedetomidine reduced the incidence of PTSD among patients with trauma. The findings of this trial support the use of dexmedetomidine in emergency trauma surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial Registration<\/jats:title><jats:p>Chinese Clinical Trial Register Identifier: <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.chictr.org.cn\/showproj.html?proj=150828\">ChiCTR2200056162<\/jats:ext-link><\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2023.18611","type":"journal-article","created":{"date-parts":[[2023,6,16]],"date-time":"2023-06-16T15:34:24Z","timestamp":1686929664000},"page":"e2318611","source":"Crossref","is-referenced-by-count":43,"title":["Effect of Dexmedetomidine on Posttraumatic Stress Disorder in Patients Undergoing Emergency Trauma Surgery"],"prefix":"10.1001","volume":"6","author":[{"given":"Youjia","family":"Yu","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Suzhou Xiangcheng People\u2019s Hospital, Suzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Suzhou Xiangcheng People\u2019s Hospital, Suzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Xuzhou Renci Hospital, Xuzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuhao","family":"Gong","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Xuzhou Renci Hospital, Xuzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liwei","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Xuzhou Central Hospital, Xuzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beiping","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Xuzhou First People\u2019s Hospital, Xuzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Yao","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Xuzhou First People\u2019s Hospital, Xuzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yangzi","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Xuzhou Central Hospital, Xuzhou, China"},{"name":"Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2023,6,16]]},"reference":[{"issue":"4","key":"zoi230567r1","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1111\/pcn.2019.73.issue-4","article-title":"Inflammation and post-traumatic stress disorder.","volume":"73","author":"Hori","year":"2019","journal-title":"Psychiatry Clin Neurosci"},{"issue":"206","key":"zoi230567r2","doi-asserted-by":"publisher","first-page":"274","DOI":"10.31729\/jnma.3108","article-title":"Updates on pharmacological treatment of post-traumatic stress disorder.","volume":"56","author":"Koirala","year":"2017","journal-title":"JNMA J Nepal Med Assoc"},{"issue":"34","key":"zoi230567r3","doi-asserted-by":"publisher","first-page":"4051","DOI":"10.2174\/1381612824666181120094749","article-title":"Synaptic plasticity in PTSD and associated comorbidities: the function and mechanism for diagnostics and therapy.","volume":"24","author":"He","year":"2018","journal-title":"Curr Pharm Des"},{"issue":"2","key":"zoi230567r4","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1007\/s11920-015-0655-0","article-title":"Prevention of post-traumatic stress disorder after trauma: current evidence and future directions.","volume":"18","author":"Qi","year":"2016","journal-title":"Curr Psychiatry Rep"},{"issue":"6","key":"zoi230567r5","doi-asserted-by":"publisher","first-page":"485","DOI":"10.1007\/s10960-004-5797-5","article-title":"Integration of psychological and biological approaches to trauma memory: implications for pharmacological prevention of PTSD.","volume":"17","author":"McCleery","year":"2004","journal-title":"J Trauma Stress"},{"issue":"1","key":"zoi230567r6","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1037\/tra0000142","article-title":"The role of oxytocin in empathy in PTSD.","volume":"9","author":"Palgi","year":"2017","journal-title":"Psychol Trauma"},{"issue":"25","key":"zoi230567r7","doi-asserted-by":"publisher","first-page":"2459","DOI":"10.1056\/NEJMra1612499","article-title":"Post-traumatic stress disorder.","volume":"376","author":"Shalev","year":"2017","journal-title":"N Engl J Med"},{"key":"zoi230567r8","doi-asserted-by":"publisher","first-page":"h6161","DOI":"10.1136\/bmj.h6161","article-title":"Post-traumatic stress disorder.","volume":"351","author":"Bisson","year":"2015","journal-title":"BMJ"},{"issue":"6","key":"zoi230567r9","doi-asserted-by":"publisher","first-page":"507","DOI":"10.1007\/s00406-016-0762-x","article-title":"Depressive, anxiety and post-traumatic stress disorders at six years after occupational injuries.","volume":"267","author":"Chin","year":"2017","journal-title":"Eur Arch Psychiatry Clin Neurosci"},{"issue":"5","key":"zoi230567r10","doi-asserted-by":"publisher","first-page":"R196","DOI":"10.1186\/cc11681","article-title":"Potential impact of propofol immediately after motor vehicle accident on later symptoms of posttraumatic stress disorder at 6-month follow up: a retrospective cohort study.","volume":"16","author":"Usuki","year":"2012","journal-title":"Crit Care"},{"issue":"5","key":"zoi230567r11","doi-asserted-by":"publisher","first-page":"444","DOI":"10.1097\/NMD.0b013e3182532312","article-title":"Posttraumatic stress disorder associated with combat service in Iraq or Afghanistan: reconciling prevalence differences between studies.","volume":"200","author":"Kok","year":"2012","journal-title":"J Nerv Ment Dis"},{"issue":"10","key":"zoi230567r12","doi-asserted-by":"publisher","first-page":"1469","DOI":"10.1017\/S0033291707000943","article-title":"A nationwide US study of post-traumatic stress after hospitalization for physical injury.","volume":"37","author":"Zatzick","year":"2007","journal-title":"Psychol Med"},{"issue":"7","key":"zoi230567r13","doi-asserted-by":"publisher","first-page":"723","DOI":"10.1037\/tra0001121","article-title":"Advancements in the understanding of PTSD and suicide risk: introduction to a special section.","volume":"13","author":"Stanley","year":"2021","journal-title":"Psychol Trauma"},{"issue":"6","key":"zoi230567r14","first-page":"546","article-title":"A review of PTSD and current treatment strategies.","volume":"118","author":"Schrader","year":"2021","journal-title":"Mo Med"},{"issue":"3","key":"zoi230567r15","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1097\/HRP.0000000000000188","article-title":"Glucocorticoids and hippocampal structure and function in PTSD.","volume":"26","author":"Szeszko","year":"2018","journal-title":"Harv Rev Psychiatry"},{"issue":"1","key":"zoi230567r16","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1007\/s00213-018-5086-2","article-title":"Reconsolidation\/destabilization, extinction and forgetting of fear memory as therapeutic targets for PTSD.","volume":"236","author":"Kida","year":"2019","journal-title":"Psychopharmacology (Berl)"},{"key":"zoi230567r17","doi-asserted-by":"publisher","DOI":"10.1016\/j.pharmthera.2020.107551","article-title":"Cannabinoids as therapeutics for PTSD.","volume":"211","author":"Sbarski","year":"2020","journal-title":"Pharmacol Ther"},{"key":"zoi230567r18","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1016\/j.neubiorev.2016.08.023","article-title":"Understanding posttraumatic stress disorder through fear conditioning, extinction and reconsolidation.","volume":"71","author":"Careaga","year":"2016","journal-title":"Neurosci Biobehav Rev"},{"key":"zoi230567r19","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1016\/j.nlm.2013.11.014","article-title":"From Pavlov to PTSD: the extinction of conditioned fear in rodents, humans, and anxiety disorders.","volume":"113","author":"VanElzakker","year":"2014","journal-title":"Neurobiol Learn Mem"},{"issue":"2","key":"zoi230567r20","doi-asserted-by":"publisher","first-page":"221","DOI":"10.1016\/j.bpa.2020.10.002","article-title":"The role of dexmedetomidine in neurosurgery.","volume":"35","author":"Tasbihgou","year":"2021","journal-title":"Best Pract Res Clin Anaesthesiol"},{"key":"zoi230567r21","doi-asserted-by":"publisher","first-page":"284","DOI":"10.1016\/j.pnpbp.2014.06.013","article-title":"Dexmedetomidine alleviates anxiety-like behaviors and cognitive impairments in a rat model of post-traumatic stress disorder.","volume":"54","author":"Ji","year":"2014","journal-title":"Prog Neuropsychopharmacol Biol Psychiatry"},{"issue":"6","key":"zoi230567r22","doi-asserted-by":"publisher","first-page":"869","DOI":"10.1345\/aph.1AR708","article-title":"Role of dexmedetomidine for the prevention and treatment of delirium in intensive care unit patients.","volume":"47","author":"Mo","year":"2013","journal-title":"Ann Pharmacother"},{"issue":"6","key":"zoi230567r23","doi-asserted-by":"publisher","first-page":"1219","DOI":"10.3906\/sag-1802-126","article-title":"The comparison between propofol and dexmedetomidine infusion on perioperative anxiety during regional anesthesia.","volume":"48","author":"Lim","year":"2018","journal-title":"Turk J Med Sci"},{"key":"zoi230567r24","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1016\/j.bbr.2017.04.048","article-title":"Effects of ketamine, dexmedetomidine and propofol anesthesia on emotional memory consolidation in rats: consequences for the development of post-traumatic stress disorder.","volume":"329","author":"Morena","year":"2017","journal-title":"Behav Brain Res"},{"issue":"9","key":"zoi230567r25","doi-asserted-by":"publisher","first-page":"993","DOI":"10.1016\/j.injury.2009.03.004","article-title":"Revisiting the validity of APACHE II in the trauma ICU: improved risk stratification in critically injured adults.","volume":"40","author":"Dossett","year":"2009","journal-title":"Injury"},{"issue":"8","key":"zoi230567r26","doi-asserted-by":"publisher","first-page":"502","DOI":"10.1136\/emermed-2019-209092","article-title":"Relationship between the Injury Severity Score and the need for life-saving interventions in trauma patients in the UK.","volume":"37","author":"Vassallo","year":"2020","journal-title":"Emerg Med J"},{"issue":"3","key":"zoi230567r27","doi-asserted-by":"publisher","first-page":"383","DOI":"10.1037\/pas0000486","article-title":"The Clinician-Administered PTSD Scale for DSM-5 (CAPS-5): development and initial psychometric evaluation in military veterans.","volume":"30","author":"Weathers","year":"2018","journal-title":"Psychol Assess"},{"issue":"12","key":"zoi230567r29","doi-asserted-by":"publisher","first-page":"941","DOI":"10.7326\/0003-4819-113-12-941","article-title":"Clarifying confusion: the confusion assessment method. a new method for detection of delirium.","volume":"113","author":"Inouye","year":"1990","journal-title":"Ann Intern Med"},{"key":"zoi230567r30","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2022.853795","article-title":"Effects of sevoflurane and propofol on posttraumatic stress disorder after emergency trauma: a double-blind randomized controlled trial.","volume":"13","author":"Zhong","year":"2022","journal-title":"Front Psychiatry"},{"issue":"3","key":"zoi230567r31","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1002\/wps.v18.3","article-title":"Post-traumatic stress disorder: a state-of-the-art review of evidence and challenges.","volume":"18","author":"Bryant","year":"2019","journal-title":"World Psychiatry"},{"issue":"6","key":"zoi230567r32","doi-asserted-by":"publisher","first-page":"e209","DOI":"10.1097\/BOT.0000000000001990","article-title":"Risk factors for posttraumatic stress disorder in acute trauma patients.","volume":"35","author":"Joseph","year":"2021","journal-title":"J Orthop Trauma"},{"issue":"7","key":"zoi230567r33","doi-asserted-by":"publisher","first-page":"583","DOI":"10.1097\/AJP.0000000000000713","article-title":"The mediating effect of pain catastrophizing on PTSD symptoms and pain outcome.","volume":"35","author":"Gilliam","year":"2019","journal-title":"Clin J Pain"},{"issue":"1","key":"zoi230567r34","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1186\/s13054-019-2489-3","article-title":"Prevalence of post-traumatic stress disorder symptoms in adult critical care survivors: a systematic review and meta-analysis.","volume":"23","author":"Righy","year":"2019","journal-title":"Crit Care"},{"issue":"11","key":"zoi230567r35","doi-asserted-by":"publisher","first-page":"1071","DOI":"10.1080\/14622200701488418","article-title":"Post-traumatic stress disorder and smoking: a systematic review.","volume":"9","author":"Fu","year":"2007","journal-title":"Nicotine Tob Res"},{"issue":"3B","key":"zoi230567r36","doi-asserted-by":"publisher","first-page":"748","DOI":"10.1590\/S0004-282X2005000500005","article-title":"Dexmedetomidine for awake craniotomy without laryngeal mask.","volume":"63","author":"Almeida","year":"2005","journal-title":"Arq Neuropsiquiatr"},{"issue":"1","key":"zoi230567r37","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1213\/01.ANE.0000094947.20838.8E","article-title":"Single-dose dexmedetomidine reduces agitation after sevoflurane anesthesia in children.","volume":"98","author":"Ibacache","year":"2004","journal-title":"Anesth Analg"},{"issue":"10054","key":"zoi230567r38","doi-asserted-by":"publisher","first-page":"1893","DOI":"10.1016\/S0140-6736(16)30580-3","article-title":"Dexmedetomidine for prevention of delirium in elderly patients after non-cardiac surgery: a randomised, double-blind, placebo-controlled trial.","volume":"388","author":"Su","year":"2016","journal-title":"Lancet"},{"issue":"6","key":"zoi230567r39","doi-asserted-by":"publisher","first-page":"1380","DOI":"10.1097\/ALN.0b013e31821c120e","article-title":"Propofol enhances memory formation via an interaction with the endocannabinoid system.","volume":"114","author":"Hauer","year":"2011","journal-title":"Anesthesiology"},{"issue":"3","key":"zoi230567r40","doi-asserted-by":"publisher","first-page":"466","DOI":"10.1016\/j.jpainsymman.2010.07.001","article-title":"Propofol.","volume":"40","author":"Lundstr\u00f6m","year":"2010","journal-title":"J Pain Symptom Manage"},{"issue":"2","key":"zoi230567r41","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1016\/j.nlm.2011.05.003","article-title":"Noradrenergic enhancement of associative fear memory in humans.","volume":"96","author":"Soeter","year":"2011","journal-title":"Neurobiol Learn Mem"},{"issue":"12","key":"zoi230567r42","doi-asserted-by":"publisher","first-page":"12358","DOI":"10.21037\/apm","article-title":"The anesthesia induction effect of dexmedetomidine in patients undergoing laryngeal mask intubation: a systematic review and meta-analysis of 7 RCTs.","volume":"10","author":"Ju","year":"2021","journal-title":"Ann Palliat Med"},{"key":"zoi230567r43","doi-asserted-by":"publisher","DOI":"10.1016\/j.janxdis.2021.102413","article-title":"The impact of sleep quality on the incidence of PTSD: results from a 7-year, nationally representative, prospective cohort of U.S. military veterans.","volume":"81","author":"DeViva","year":"2021","journal-title":"J Anxiety Disord"},{"issue":"2","key":"zoi230567r44","doi-asserted-by":"publisher","first-page":"208","DOI":"10.1080\/15402002.2020.1726749","article-title":"Sleep quality moderates the relationship between anxiety sensitivity and PTSD symptoms in combat-exposed veterans.","volume":"19","author":"McNett","year":"2021","journal-title":"Behav Sleep Med"},{"issue":"6","key":"zoi230567r45","doi-asserted-by":"publisher","first-page":"1738","DOI":"10.1212\/CON.0000000000001054","article-title":"Posttraumatic stress disorder and anxiety-related conditions.","volume":"27","author":"Williamson","year":"2021","journal-title":"Continuum (Minneap Minn)"},{"issue":"2","key":"zoi230567r46","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1097\/PSY.0000000000000899","article-title":"Posttraumatic stress disorder and chronic pain conditions in men: a twin study.","volume":"83","author":"Gasperi","year":"2021","journal-title":"Psychosom Med"},{"issue":"10","key":"zoi230567r47","doi-asserted-by":"publisher","first-page":"2737","DOI":"10.1007\/s10072-020-04458-7","article-title":"Post-traumatic stress disorder after traumatic brain injury-a systematic review and meta-analysis.","volume":"41","author":"Iljazi","year":"2020","journal-title":"Neurol Sci"},{"key":"zoi230567r28","doi-asserted-by":"crossref","DOI":"10.1176\/appi.books.9780890425596","volume-title":"Diagnostic and Statistical Manual of Mental Disorders","author":"American Psychiatric Association","year":"2013","edition":"5th ed"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2806183\/yu_2023_oi_230567_1686250798.35674.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,6,16]],"date-time":"2023-06-16T15:34:29Z","timestamp":1686929669000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2806183"}},"subtitle":["A Randomized Clinical Trial"],"short-title":[],"issued":{"date-parts":[[2023,6,16]]},"references-count":47,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2023,6,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2023.18611","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6,16]]}}}