Effects of Perioperative Intranasal Dexmedetomidine Spray on Clinical Outcomes of Pulsed Radiofrequency in Patients with Zoster-Associated Pain: A Randomized Controlled Trial.
Yi Wang, Mengjuan Dong, Miaomaio Xu, Huaichang Wen
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引用次数: 0
Abstract
Objective: To investigate the effects of perioperative intranasal dexmedetomidine spray on hemodynamic stability, postoperative analgesia and sleep quality in patients with zoster-associated pain (ZAP) undergoing pulsed radiofrequency (PRF), and assess its clinical efficacy and safety.
Methods: A single-center, randomized, double-blind, parallel-controlled trial was conducted. Sixty-eight ZAP patients receiving dorsal root ganglion PRF were randomly assigned (1:1) to the dexmedetomidine (Dex) group or control group. The Dex group received intranasal dexmedetomidine 40 μg 30 min preoperatively, followed by 40 μg twice daily for 3 postoperative days; the control group received equal-volume normal saline at matched time points. Perioperative mean arterial pressure (MAP) and heart rate (HR) were recorded. Pain intensity (VAS) and sleep quality (PSQI) were assessed at baseline and on postoperative days 1, 3, 7 and 14. The primary outcome was change in MAP from baseline to PRF treatment stage. Linear mixed-effects models were used for longitudinal analyses.
Results: Baseline characteristics were comparable between groups (all P>0.05). The Dex group showed significantly smaller MAP and HR fluctuations during puncture, nerve stimulation and PRF treatment (group × time interaction, all P<0.001). VAS and PSQI scores were markedly lower in the Dex group at all postoperative time points (all P<0.001 after Bonferroni correction). No severe adverse events occurred; mild-to-moderate transient bradycardia and hypotension in the Dex group required no specific intervention.
Conclusion: Perioperative intranasal dexmedetomidine spray effectively stabilizes perioperative hemodynamics, improves postoperative analgesia and sleep quality in ZAP patients undergoing PRF, with no serious safety signals observed in this study population. It provides evidence for optimized perioperative management strategies in this population.
Trial registration: Chinese Clinical Trial Registry, ChiCTR2500098608, first posted 11/03/2025.
期刊介绍：
Journal of Pain Research is an international, peer-reviewed, open access journal that welcomes laboratory and clinical findings in the fields of pain research and the prevention and management of pain. Original research, reviews, symposium reports, hypothesis formation and commentaries are all considered for publication. Additionally, the journal now welcomes the submission of pain-policy-related editorials and commentaries, particularly in regard to ethical, regulatory, forensic, and other legal issues in pain medicine, and to the education of pain practitioners and researchers.
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