Related Experiment Video
Updated: Jun 15, 2025
Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
Association of Dexmedetomidine With Postoperative Depressive Symptoms in Older Surgical Patients: A Prospective
Xinyu Hao1, Zhuoning Zhang1, Lujia Yang1
1Department of Anesthesiology, The First Medical Centre, Chinese PLA General Hospital, Beijing, China.
Background:
Neuropsychiatric symptoms significantly impact surgical recovery, quality of life, and long-term survival. To investigate the association between intraoperative dexmedetomidine administration and the incidence of postoperative depressive symptoms in noncardiac surgical patients.
Methods:
A multicenter prospective observational study of older surgical patients over 65 years of age from April 2020 to April 2022. The primary outcome was the incidence of postoperative 7-day depressive symptoms. Secondary outcomes were the incidence of postoperative 7-day anxiety symptoms, sleep disturbance, and delirium. A logistic regression model based on the random effect was used to determine the association between dexmedetomidine administration and the outcomes. Propensity score matching (PSM) and inverse probability treatment weighting (IPTW) were employed to address data imbalance. Subgroup analyses based on specific populations were performed to explore the relationship between dexmedetomidine and depressive symptoms.
Results:
Of 5591 patients, 20.5% (1148) received intraoperative dexmedetomidine. The incidence of postoperative 7-day depressive symptoms was significantly lower in the dexmedetomidine group compared to the nondexmedetomidine group (unadjusted: 7.6% vs. 26.7%, p < 0.001; PSM: 7.9% vs. 29.0%, IPTW: 8.7% vs. 25.8%, p < 0.001). Dexmedetomidine was significantly associated with the remission of postoperative 7-day depressive symptoms (adjusted random-effect model: risk ratio [RR] 0.104, 95% CI, 0.080-0.140, p < 0.001; PSM: RR 0.311, 95% CI, 0.242-0.415, p < 0.001; IPTW: RR 0.297, 95% CI, 0.253-0.343, p < 0.001). Additionally, dexmedetomidine demonstrated protective effects against postoperative anxiety symptoms, sleep disturbance, and delirium. In age, gender, cumulative comorbidity, frailty, ASA physical status, and inhaled anesthetic subgroups, we also found that dexmedetomidine was associated with a reduction in postoperative depressive symptoms in older noncardiac patients.
Conclusion:
Intraoperative dexmedetomidine administration was associated with a reduction in postoperative 7-day depressive symptoms, anxiety symptoms, sleep disturbances, and delirium in older patients undergoing noncardiac surgery.
Trial Registration:
The clinical trial protocol of this study was registered in the Clinical Trial registry (NCT06362408).
Prior Presentations:
The authors have nothing to report.
Related Concept Videos
01:24Parenteral Anesthetics: Overview
01:17Sedatives and Hypnotics Drugs: Miscellaneous Agents
Melatonin congeners like ramelteon (Rozerem) and tasimelteon (Hetlioz) selectively bind to melatonin receptors (MT1 and MT2) and thus mimic the actions of melatonin, a hormone that regulates sleep-wake cycles. Tasimelteon is primarily used for non-24-hour sleep-wake disorder, common in blind patients. They are also used to treat conditions like insomnia...
01:22Stages of General Anesthesia
01:24General Anesthesia: Overview
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
01:19Sedatives and Hypnotics Drugs: Benzodiazepines
Benzodiazepines work by enhancing the effects of the inhibitory neurotransmitter GABA. They bind to the GABAA receptor, increasing its affinity for GABA, which opens chloride...
01:23Sedatives and Hypnotics: Overview
Sedative-hypnotics are categorized into barbiturates, benzodiazepines (BZDs), and non-benzodiazepines or Z-drugs. These drugs work by suppressing central nervous system activity, and this suppression is dose-dependent. Older sedative medications, like barbiturates, follow a linear curve in...