{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T05:55:35Z","timestamp":1790920535115,"version":"4.1.0"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T00:00:00Z","timestamp":1790899200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"\n Background<\/jats:title>\n Postoperative pulmonary complications (PPCs) ranging from 30% to 50% have been recognized as a major threat to postoperative recovery. Current conventional interventions cannot effectively reduce the occurrence of PPCs.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n In this study, we aimed to investigate the effects of multiple low-dose intranasal dexmedetomidine administration on PPCs in elderly patients.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n In this double-blind, randomized, controlled trial, elderly patients were randomly assigned at a 1:1 ratio to receive multiple low-dose intranasal dexmedetomidine administration (MD group) or normal saline nasal spray (NS group). The primary outcome was the incidence of PPCs within 7 days after surgery. Key secondary outcomes included the severity grading and classification of PPCs. Other secondary outcomes included serum interleukin-6 (IL-6) and tumor necrosis factor-\u03b1 (TNF-\u03b1) levels, Richards-Campbell sleep questionnaire (RCSQ) scores at predefined time points, and adverse reactions.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 190 patients were screened, and 186 completed the study. The incidence of PPCs was significantly lower in the MD group than in the NS group (9.68% vs. 22.58%,\n P<\/jats:italic>\n = 0.017), with a risk ratio (RR) of 2.333 [95% confidence interval (CI): 1.173\u20136.317], absolute risk reduction (ARR) of 12.90%, and number needed to treat (NNT) of 7.75. Sensitivity analyses using the per-protocol population (PP) dataset yielded consistent results, confirming the stability and reliability of the primary outcome. The distribution of severity grading of PPCs also differed significantly between the groups (\n P<\/jats:italic>\n = 0.036). After Bonferroni correction, the between-group difference in PPCs severity grading was not statistically significant (corrected\n P<\/jats:italic>\n = 0.072). The distribution of pneumonia also differed significantly between the groups (\n P<\/jats:italic>\n = 0.029). There were significant group effects, time effects, and interaction effects for IL-6, TNF-\u03b1, and RCSQ in the two groups after surgery (all\n P<\/jats:italic>\n &lt; 0.05). No significant between-group differences were observed in drug-related adverse events.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Multiple low-dose intranasal dexmedetomidine administration significantly reduces the incidence of PPCs in elderly patients undergoing radical thoracoscopic lung-cancer resection with a favorable safety profile.<\/jats:p>\n <\/jats:sec>\n \n Clinical Trial Registration<\/jats:title>\n \n https:\/\/www.chictr.org.cn\/showproj.html?proj=243165<\/jats:ext-link>\n ; identifier ChiCTR2400090593.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fphar.2026.1914046","type":"journal-article","created":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T05:36:09Z","timestamp":1790919369000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Effects of multiple low-dose intranasal dexmedetomidine administration on postoperative pulmonary complications in elderly patients undergoing thoracoscopic radical resection of lung cancer: a single-center randomized controlled trial"],"prefix":"10.3389","volume":"17","author":[{"given":"Bing","family":"Li","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Perioperative Medicine, Henan Provincial People\u2019s Hospital","place":["Zhengzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yao","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, People\u2019s Hospital of Zhengzhou","place":["Zhengzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinmin","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Perioperative Medicine, Henan Provincial People\u2019s Hospital","place":["Zhengzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengyan","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Perioperative Medicine, Henan Provincial People\u2019s Hospital","place":["Zhengzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xing","family":"Meng","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Perioperative Medicine, Henan Provincial People\u2019s Hospital","place":["Zhengzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingyang","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Perioperative Medicine, Henan Provincial People\u2019s Hospital","place":["Zhengzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaqiang","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Perioperative Medicine, Henan Provincial People\u2019s Hospital","place":["Zhengzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Perioperative Medicine, Henan Provincial People\u2019s Hospital","place":["Zhengzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,10,2]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1066","DOI":"10.1016\/j.bja.2018.02.007","article-title":"A systematic review and consensus definitions for standardised end-points in perioperative medicine: pulmonary complications","volume":"120","author":"Abbott","year":"2018","journal-title":"Br. 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