{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T02:40:08Z","timestamp":1792464008337,"version":"4.5.0"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T00:00:00Z","timestamp":1784851200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T00:00:00Z","timestamp":1792454400000},"content-version":"vor","delay-in-days":88,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Anesthesiol"],"DOI":"10.1186\/s12871-026-04070-w","type":"journal-article","created":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T07:13:59Z","timestamp":1784877239000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Dexmedetomidine-based opioid-sparing anesthesia in video-assisted thoracoscopic surgery: a randomized controlled trial"],"prefix":"10.1186","volume":"26","author":[{"given":"Kai-Wei","family":"Hsieh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun-Hsien","family":"Wen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen-Hsiu","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,24]]},"reference":[{"key":"4070_CR1","doi-asserted-by":"publisher","first-page":"2417","DOI":"10.1016\/j.athoracsur.2015.11.055","volume":"101","author":"W Zhang","year":"2016","unstructured":"Zhang W, Wei Y, Jiang H, et al. Video-assisted thoracoscopic surgery versus thoracotomy lymph node dissection in clinical stage I lung cancer: a meta-analysis and system review. Ann Thorac Surg. 2016;101:2417\u201324.","journal-title":"Ann Thorac Surg"},{"key":"4070_CR2","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1186\/s13019-020-01305-w","volume":"15","author":"G Batihan","year":"2020","unstructured":"Batihan G, Ceylan KC, Usluer O, Kaya \u015e\u00d6. Video-assisted thoracoscopic surgery vs thoracotomy for non-small cell lung cancer greater than 5\u00a0cm: is VATS a feasible approach for large tumors? J Cardiothorac Surg. 2020;15:261.","journal-title":"J Cardiothorac Surg"},{"key":"4070_CR3","first-page":"333","volume":"9","author":"SJ Hyland","year":"2021","unstructured":"Hyland SJ, Brockhaus KK, Vincent WR, et al. Perioperative pain management and opioid stewardship: a practical guide. Healthc (Basel). 2021;9:333.","journal-title":"Healthc (Basel)"},{"issue":"Suppl 4","key":"4070_CR4","doi-asserted-by":"publisher","first-page":"S555","DOI":"10.21037\/jtd.2017.12.86","volume":"10","author":"F Piccioni","year":"2018","unstructured":"Piccioni F, Segat M, Falini S, et al. Enhanced recovery pathways in thoracic surgery from Italian VATS Group: perioperative analgesia protocols. J Thorac Dis. 2018;10(Suppl 4):S555\u201363.","journal-title":"J Thorac Dis"},{"key":"4070_CR5","doi-asserted-by":"publisher","first-page":"2544","DOI":"10.21037\/jtd-22-50","volume":"14","author":"Y Qiu","year":"2022","unstructured":"Qiu Y, Lu X, Liu Y, et al. Efficacy of the intraoperative opioid-sparing anesthesia on quality of patients\u2019 recovery in video-assisted thoracoscopic surgery: a randomized trial. J Thorac Dis. 2022;14:2544\u201355.","journal-title":"J Thorac Dis"},{"key":"4070_CR6","doi-asserted-by":"publisher","first-page":"256","DOI":"10.21037\/jtd-22-1556","volume":"15","author":"GF Gilson","year":"2023","unstructured":"Gilson GF, Khandhar SJ. Opioid-sparing opportunities in the thoracic surgery pathway. J Thorac Dis. 2023;15:256\u20139.","journal-title":"J Thorac Dis"},{"key":"4070_CR7","doi-asserted-by":"publisher","first-page":"382","DOI":"10.1097\/00000542-200008000-00016","volume":"93","author":"TJ Ebert","year":"2000","unstructured":"Ebert TJ, Hall JE, Barney JA, et al. The effects of increasing plasma concentrations of dexmedetomidine in humans. Anesthesiology. 2000;93:382\u201394.","journal-title":"Anesthesiology"},{"key":"4070_CR8","doi-asserted-by":"crossref","unstructured":"Gertler R, Brown HC, Mitchell DH, Silvius EN. Dexmedetomidine: a novel sedative-analgesic agent. Baylor Univ Med Cent Proc. 2001;14:13\u201321.","DOI":"10.1080\/08998280.2001.11927725"},{"key":"4070_CR9","doi-asserted-by":"publisher","first-page":"111345","DOI":"10.1016\/j.jclinane.2023.111345","volume":"93","author":"A Zorrilla-Vaca","year":"2024","unstructured":"Zorrilla-Vaca A, Grant MC, Law M, et al. Dexmedetomidine improves pulmonary outcomes in thoracic surgery under one-lung ventilation: a meta-analysis. J Clin Anesth. 2024;93:111345.","journal-title":"J Clin Anesth"},{"key":"4070_CR10","doi-asserted-by":"publisher","first-page":"296","DOI":"10.1186\/s13019-020-01346-1","volume":"15","author":"YL Wang","year":"2020","unstructured":"Wang YL, Kong XQ, Ji FH. Effect of dexmedetomidine on intraoperative Surgical Pleth Index in patients undergoing video-assisted thoracoscopic lung lobectomy. J Cardiothorac Surg. 2020;15:296.","journal-title":"J Cardiothorac Surg"},{"key":"4070_CR11","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1186\/s13019-022-01803-z","volume":"17","author":"C Song","year":"2022","unstructured":"Song C, Lu Q. Effect of dexmedetomidine supplementation for thoracoscopic surgery: a meta-analysis of randomized controlled trials. J Cardiothorac Surg. 2022;17:70.","journal-title":"J Cardiothorac Surg"},{"key":"4070_CR12","doi-asserted-by":"publisher","first-page":"891096","DOI":"10.3389\/fmed.2022.891096","volume":"9","author":"B Li","year":"2022","unstructured":"Li B, Zhao Y, Liu X, et al. The optimal dose of intraoperative dexmedetomidine for antiemetic effects of post-operative nausea and vomiting in patients undergoing elective thoracic surgery: a retrospective cohort study. Front Med (Lausanne). 2022;9:891096.","journal-title":"Front Med (Lausanne)"},{"key":"4070_CR13","doi-asserted-by":"publisher","first-page":"e2854","DOI":"10.1097\/MD.0000000000002854","volume":"95","author":"SH Lee","year":"2016","unstructured":"Lee SH, Lee CY, Lee JG, et al. Intraoperative dexmedetomidine improves the quality of recovery and postoperative pulmonary function in patients undergoing video-assisted thoracoscopic surgery: a CONSORT-prospective, randomized, controlled trial. Med (Baltim). 2016;95:e2854.","journal-title":"Med (Baltim)"},{"key":"4070_CR14","doi-asserted-by":"publisher","first-page":"1263","DOI":"10.1016\/j.surg.2024.06.001","volume":"176","author":"S Zhong","year":"2024","unstructured":"Zhong S, Sun Q, Wen J, et al. Dexmedetomidine attenuates inflammatory response and chronic pain following video-assisted thoracoscopic surgery for lung cancer. Surgery. 2024;176:1263\u201372.","journal-title":"Surgery"},{"key":"4070_CR15","doi-asserted-by":"publisher","first-page":"10495","DOI":"10.2147\/DDDT.S560044","volume":"19","author":"KC Hung","year":"2025","unstructured":"Hung KC, Chang LC, Lai YC, et al. Perioperative dexmedetomidine exposure and one-year mortality risk after video-assisted thoracoscopic surgery: a multi-institutional study. Drug Des Devel Ther. 2025;19:10495\u2013506.","journal-title":"Drug Des Devel Ther"},{"key":"4070_CR16","doi-asserted-by":"publisher","first-page":"871","DOI":"10.2147\/DDDT.S195221","volume":"13","author":"X Kang","year":"2019","unstructured":"Kang X, Tang X, Yu Y, et al. Intraoperative dexmedetomidine infusion is associated with reduced emergence agitation and improved recovery profiles after lung surgery: a retrospective cohort study. Drug Des Devel Ther. 2019;13:871\u20139.","journal-title":"Drug Des Devel Ther"},{"key":"4070_CR17","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1097\/EJA.0000000000000405","volume":"33","author":"SH Lee","year":"2016","unstructured":"Lee SH, Kim N, Lee CY, et al. Effects of dexmedetomidine on oxygenation and lung mechanics in patients with moderate chronic obstructive pulmonary disease undergoing lung cancer surgery: a randomised double-blinded trial. Eur J Anaesthesiol. 2016;33:275\u201382.","journal-title":"Eur J Anaesthesiol"},{"key":"4070_CR18","doi-asserted-by":"publisher","first-page":"568","DOI":"10.1016\/j.jcrc.2009.05.015","volume":"24","author":"AT Gerlach","year":"2009","unstructured":"Gerlach AT, Dasta JF, Steinberg S, et al. A new dosing protocol reduces dexmedetomidine-associated hypotension in critically ill surgical patients. J Crit Care. 2009;24:568\u201374.","journal-title":"J Crit Care"},{"key":"4070_CR19","doi-asserted-by":"publisher","first-page":"187","DOI":"10.4103\/0970-9185.209753","volume":"33","author":"B Jebaraj","year":"2017","unstructured":"Jebaraj B, Ramachandran R, Rewari V, et al. Feasibility of dexmedetomidine as sole analgesic agent during robotic urological surgery: a pilot study. J Anaesthesiol Clin Pharmacol. 2017;33:187\u201392.","journal-title":"J Anaesthesiol Clin Pharmacol"},{"key":"4070_CR20","doi-asserted-by":"publisher","first-page":"35","DOI":"10.4103\/joacp.JOACP_143_17","volume":"34","author":"S Tripathy","year":"2018","unstructured":"Tripathy S, Rath S, Agrawal S, et al. Opioid-free anesthesia for breast cancer surgery: an observational study. J Anaesthesiol Clin Pharmacol. 2018;34:35\u201340.","journal-title":"J Anaesthesiol Clin Pharmacol"},{"key":"4070_CR21","doi-asserted-by":"publisher","first-page":"6581","DOI":"10.3390\/jcm13216581","volume":"13","author":"M Kim","year":"2024","unstructured":"Kim M, Huh J, Choi H, et al. No difference in postoperative recovery outcomes between opioid-free and opioid-sparing anesthesia under multimodal analgesic protocol for video-assisted thoracoscopic surgery: a propensity score matching cohort study. J Clin Med. 2024;13:6581.","journal-title":"J Clin Med"},{"key":"4070_CR22","doi-asserted-by":"publisher","first-page":"1714040","DOI":"10.3389\/fanes.2025.1714040","volume":"4","author":"A Pershad","year":"2025","unstructured":"Pershad A, Elvir Lazo OL, Wong R. Opioid-free anesthesia: a scoping review of efficacy, safety, and implementation challenges. Front Anesthesiol. 2025;4:1714040.","journal-title":"Front Anesthesiol"},{"key":"4070_CR23","doi-asserted-by":"publisher","first-page":"881","DOI":"10.3390\/jpm14080881","volume":"14","author":"H Choi","year":"2024","unstructured":"Choi H, Huh J, Kim M, et al. Opioid-free using ketamine versus opioid-sparing anesthesia during the intraoperative period in video-assisted thoracoscopic surgery: a randomized controlled trial. J Pers Med. 2024;14:881.","journal-title":"J Pers Med"},{"key":"4070_CR24","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1186\/s12871-023-02032-0","volume":"23","author":"HH Ke","year":"2023","unstructured":"Ke HH, Liou JY, Teng WN, et al. Opioid-sparing anesthesia with dexmedetomidine provides stable hemodynamic and short hospital stay in non-intubated video-assisted thoracoscopic surgery: a propensity score matching cohort study. BMC Anesthesiol. 2023;23:110.","journal-title":"BMC Anesthesiol"},{"key":"4070_CR25","doi-asserted-by":"publisher","first-page":"1641","DOI":"10.2147\/DDDT.S405990","volume":"17","author":"JJ Sun","year":"2023","unstructured":"Sun JJ, Xiang XB, Xu GH, et al. A novel opioid-sparing analgesia following thoracoscopic surgery: a non-inferiority trial. Drug Des Devel Ther. 2023;17:1641\u201350.","journal-title":"Drug Des Devel Ther"}],"container-title":["BMC Anesthesiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12871-026-04070-w","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12871-026-04070-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12871-026-04070-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T02:16:28Z","timestamp":1792462588000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12871-026-04070-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,24]]},"references-count":25,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["4070"],"URL":"https:\/\/doi.org\/10.1186\/s12871-026-04070-w","relation":{},"ISSN":["1471-2253"],"issn-type":[{"value":"1471-2253","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,24]]},"assertion":[{"value":"2 June 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 June 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 July 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This study was approved by the Institutional Review Board of Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan (approval number: KSVGH22-CT2-20). Written informed consent was obtained from all participants before enrollment. All procedures performed in this study involving human participants were conducted in accordance with the ethical standards of the institutional research committee and with the Declaration of Helsinki and its later amendments or comparable ethical standards.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Is not applicable for this study.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"632"}}