Clinical efficacy observation of intranasal dexmedetomidine spray in adults undergoing lower extremity orthopedic surgery under general anesthesia

Abstract

Objective: This study aimed to evaluate the sedative effects of intranasal dexmedetomidine spray in adult patients undergoing lower limb orthopedic surgery under general anesthesia and to analyze its role in reducing preoperative anxiety.
Methods: From July 2024 to January 2025, a total of 120 adult patients undergoing lower limb orthopedic surgery under general anesthesia at our medical institution were randomly assigned to either the experimental group (EG) or the control group (CG), with 60 patients in each group. Patients in the experimental group received intranasal dexmedetomidine spray 30 minutes before surgery, whereas those in the control group received intravenous midazolam over the same period. Sedation level, anxiety level, vital signs, anesthesia recovery, and incidence of adverse reactions were assessed.
Results: The Sedation scores significantly increased after drug intervention in both groups compared to the pre-administration baseline. The STAI scores in the experimental group were lower than those in the control group, although the difference was not statistically significant. Baseline values of Heart Rate (HR), Mean Arterial Pressure (MAP), and Pulse Oxygen Saturation (SpO₂) showed no significant differences between the two groups before drug administration. HR, MAP, and SpO₂ tended to decrease in both intervention groups compared with baseline values, but no pathological changes were observed. The experimental group had significantly shorter times in spontaneous breathing recovery, awakening, and extubating than the control group. The incidence of adverse reactions was 5.0% in the treatment group, significantly lower than the 28.4% in the  control group.
Conclusion: Intranasal dexmedetomidine spray significantly enhances sedation levels, alleviates preoperative anxiety, and demonstrates good safety in adult patients undergoing lower limb orthopedic surgery under general anesthesia.