Dexmedetomidine plus sufentanil cuts postoperative delirium risk to 4.9% vs 15.28% with sufentanil alone

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International journal of clinical pharmacology and therapeutics Published June 1, 2026 Medically reviewed June 1, 2026 Study authors: Li Fujing, Zhang Weizhou, Huo Jian, Cheng Liming, Zhao Rui PubMed ↗ DOI ↗ By Dr. Ji-eun Park, MD · Brain, Mind & Pain

Key Takeaway

Consider dexmedetomidine-sufentanil for reducing postoperative delirium in elderly thoracic surgery patients.

This randomized controlled trial enrolled 287 elderly patients aged 65 years and older scheduled for thoracoscopic lung surgery. The intervention group received IV patient-controlled dexmedetomidine injections combined with sufentanil (3 μg×kg sufentanil and 3 μg×kg DEX), while the comparator group received IV patient-controlled sufentanil injections (3 μg×kg sufentanil). The primary outcome was the incidence of postoperative delirium (POD) over a 7-day follow-up period.

The main result showed a significantly lower incidence of POD in the dexmedetomidine-sufentanil group at 4.9% compared to 15.28% in the sufentanil-only group (p = 0.006). No significant differences were found for secondary outcomes including duration of POD, incidence of postoperative nausea and vomiting, postoperative hospitalization duration, or pain assessment.

Safety data indicated that the incidence of hypertension was significantly lower in the test group (p < 0.001). No differences were found for other adverse events. Serious adverse events, discontinuations, and tolerability were not reported.

Key limitations include the lack of reported funding or conflicts, and the absence of specified practice relevance. The study population was limited to elderly patients undergoing a specific surgical procedure. These findings suggest a potential role for dexmedetomidine-sufentanil combination in reducing delirium risk, but broader applicability requires further investigation.

Study Details

Study typeRct

Sample sizen = 287

EvidenceLevel 2

Follow-up780.0 mo

PublishedJun 2026

PMID41914613

View Original Abstract ↓

OBJECTIVE: This study aimed to investigate the effect of intravenous (IV) patient-controlled anesthesia (PCA) combined with dexmedetomidine (DEX) injections on reducing the risk of postoperative delirium (POD) in elderly patients undergoing thoracoscopic lung surgery, hypothesizing a potential risk reduction. MATERIALS AND METHODS: Patients aged 65 years and older who underwent thoracoscopic lung surgery were assessed for eligibility. The participants were randomly assigned to either the test or control group. The test group received DEX through an IV PCA pump, consisting of 3 μg×kg sufentanil and 3 μg×kg DEX, while the control group received 3 μg×kg sufentanil. PCA parameters were standardized, including a total volume of 150 mL, a 2-mL bolus dose with a 15-minute lock-out period, and a background infusion rate of 2 mL/h. The primary outcome was the incidence of POD, which was evaluated twice daily for 7 days after surgery. The secondary outcomes included duration of POD, incidence of postoperative nausea and vomiting (PONV), postoperative hospitalization duration, pain assessment, and adverse events. RESULTS: A total of 287 patients were recruited. The incidence of POD in the control group was significantly higher (15.28 vs. 4.9%, p = 0.006). There were no significant differences in POD duration, PONV, or the length of hospital stay after operation between the two groups. The incidence of hypertension in the test group was significantly lower (p < 0.001), and no differences were found for other adverse events. CONCLUSION: IV patient-controlled DEX injections after major thoracoscopic lung surgery can reduce postoperative delirium.