ORIGINAL RESEARCH article
Front. Pharmacol.
Sec. Translational Pharmacology
Intraoperative dexmedetomidine use associated with prolonged postanesthesia care unit recovery time after lung resection: a retrospective cohort study
Provisionally accepted
- 1Department of Anesthesiology, Panzhihua Central Hospital, Panzhihua, China
- 2Department of Nuclear Medicine, Panzhihua Central Hospital, Panzhihua, China
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Background: Dexmedetomidine, despite its wide-ranging benefits, may also pose a risk of delayed recovery in the postanesthesia care unit (PACU). Few studies have shown the relationship between dexmedetomidine and delayed recovery in PACU after lung resection. Therefore, this retrospective cohort study aimed to investigate the effect of dexmedetomidine on PACU recovery time. Methods: This study identified 1,397 eligible patients (dexmedetomidine-free (NO-DEX) group, n = 638, intraoperative dexmedetomidine use (DEX) group, n = 759), among 1,980 patients undergoing lung resection from January 2020 to December 2023. Primary outcome was the relationship between dexmedetomidine exposure and the risk of prolonged PACU recovery time; secondary outcomes were independent risk factors affecting PACU recovery time. The data were analyzed using propensity score matching and univariate and multivariate logistic regression analyses as appropriate. In addition, we also developed a nomogram, which was evaluated by calibration curve, receiver operating characteristic (ROC) curve, and decision curve analysis (DCA). Results: After propensity score matching, there were 521 patients in each group. The incidence of PACU recovery time exceeding 60 minutes was 25.48%. Univariate logistic regression analysis showed that intraoperative dexmedetomidine use was associated with risk of prolonged PACU recovery time (odds ratio (OR): 1.58; 95% confidence interval (CI): 1.18, 2.11; P = 0.002). Multivariate logistic regression analysis also showed a significant difference in risk of prolonged PACU recovery time (OR: 1.60; 95% CI: 1.19-2.15; P = 0.002) between NO-DEX and DEX groups. Sensitivity analyses under varying assumptions confirmed the robustness of our primary results. Independent risk factors for delayed recovery in PACU included intraoperative dexmedetomidine use, advanced age, smoking, cardiovascular disease, and ASA physical status III, whereas regional block was associated with reduced risk. The predictive nomogram demonstrated moderate discrimination and estimated a 70% probability of delayed PACU recovery in patients presenting with all identified risk factors. Conclusion: Our data demonstrated that intraoperative dexmedetomidine use was associated with prolonged PACU recovery time following lung resection, potentially increasing pressure on busy recovery rooms.
Keywords: Dexmedetomidine, Postanesthesia Care Unit, Delayed recovery, riskfactor, Lung resection
Received: 18 Jun 2025; Accepted: 10 Nov 2025.
Copyright: © 2025 Gao, Jiang, Liu, Yang, Zhang and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Ming Li, liming199408@163.com
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