Evaluation of intranasal dexmedetomidine on perioperative comfort evaluated using the General Comfort Questionnaire.

Abstract

Objectives: Impaired clinical comfort has been shown to compromise in-hospital care quality and patient safety metrics. Therefore, optimizing perioperative comfort through evidence-based multimodal interventions has emerged as a paramount clinical priority in contemporary surgical and anesthesia practice. This study aimed to investigate the effects of intranasal administration of dexmedetomidine hydrochloride on comfort improvement in patients who underwent neuraxial anesthesia or nerve block anesthesia and to explore the risk factors for discomfort.

Methods: We retrospectively analyzed cohort data from 350 patients who underwent neuraxial anesthesia or nerve block anesthesia at Xuzhou Renci Hospital between January and September 2024. The patients were divided into a control group and a dexmedetomidine group on the basis of whether intranasal administration of dexmedetomidine hydrochloride was used. The primary endpoint was the General Comfort Questionnaire (GCQ) score after surgery. The secondary endpoints included the VAS score, the Pittsburgh Sleep Quality Index (PSQI) score, and changes in blood pressure and heart rate. A multivariable logistic regression model was used to screen for risk factors associated with discomfort.

Results: In this study, 200 patients underwent conventional anesthesia, and the remaining 150 patients were first administered dexmedetomidine hydrochloride intranasally before anesthesia induction. At various time points after surgery, the GCQ scores of patients in the dexmedetomidine group were consistently higher than those of patients in the control group (p < 0.001). The mean arterial blood pressure, heart rate, PSQI score, and VAS score were lower in the dexmedetomidine group than in the control group (p < 0.001). In the multivariable analysis, intervention (OR, 0.01; 95% CI, 0.00-0.05), age (OR, 1.17; 95% CI, 1.11-1.24), male sex (OR, 0.62; 95% CI, 0.41-0.95), sleep quality (OR, 1.57; 95% CI, 1.38-1.79) and pain catastrophizing scale score (OR, 1.08; 95% CI, 1.02-1.14) were independently associated with the GCQ score.

Conclusions: These findings indicate that intranasal administration of dexmedetomidine hydrochloride significantly enhanced patient comfort, as evidenced by elevated GCQ scores, reduced VAS scores, and significantly improved postoperative sleep quality. Age, sex, sleep quality and pain catastrophizing scale scores were found to be independent factors for discomfort.