Dexmedetomidine Shows Promise in Reducing Postoperative PTSD in Trauma Patients

Posttraumatic stress disorder (PTSD) is a common psychological condition that affects individuals who have experienced trauma, including those who undergo surgery. However, a recent study published in JAMA Network Open has shed light on a potential preventive measure. Researchers have found that the administration of low-dose intravenous dexmedetomidine during and after emergency surgery can significantly reduce the occurrence of PTSD in trauma patients. These findings offer hope for improving the mental health outcomes of individuals recovering from traumatic experiences.

The study, a double-blind, randomized clinical trial, was conducted by Ypujia Yu and team at four hospital centres in Jiangsu Province, China. It included 310 patients who underwent emergency surgery following trauma. The participants were divided into two groups: one received dexmedetomidine, while the other received a placebo (normal saline).

The primary outcome measure was the difference in the incidence of PTSD one month after surgery, evaluated using the Clinician-Administered PTSD Scale for Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) (CAPS-5). Secondary outcomes included pain scores within 48 hours and one month postoperatively, postoperative delirium, nausea, pruritus, subjective sleep quality, anxiety, and occurrence of adverse events.

● The results of the trial demonstrated encouraging findings. One month after surgery, the incidence of PTSD was significantly lower in the dexmedetomidine group compared to the control group (14.1% vs. 24.0%; P = .03).

● Additionally, patients who received dexmedetomidine had significantly lower CAPS-5 scores, indicating reduced severity of PTSD symptoms (17.3 [5.3] vs. 18.9 [6.6]; mean difference, 1.65; 95% CI, 0.31-2.99; P = .02).

● After adjusting for potential confounders, the patients in the dexmedetomidine group were found to be significantly less likely to develop PTSD compared to the control group one month postoperatively (adjusted odds ratio, 0.51; 95% CI, 0.27-0.94; P = .03).

The results of this study highlight the potential of dexmedetomidine in reducing the incidence and severity of postoperative PTSD in trauma patients. By incorporating this medication during and after emergency surgery, healthcare professionals may enhance patients' psychological recovery and improve their overall well-being. Further research is necessary to explore the underlying mechanisms through which dexmedetomidine influences fear memory consolidation and the development of PTSD. Additionally, future JAMA Network Openstudies should examine the effectiveness of dexmedetomidine in larger populations and different types of surgical procedures.

The findings of this groundbreaking study indicate that the administration of intraoperative and postoperative dexmedetomidine significantly reduces the incidence of PTSD among trauma patients undergoing emergency surgery. This discovery holds significant promise for improving the mental health outcomes of individuals recovering from traumatic experiences. By addressing both the physical and psychological aspects of trauma, healthcare providers

can enhance the overall recovery process for patients undergoing surgery after trauma. The study's results warrant further investigation into the potential applications of dexmedetomidine in preventing postoperative psychiatric complications and emphasize the importance of a holistic approach to patient care.

Reference:

Yu, Y., Li, Y., Han, D., Gong, C., Wang, L., Li, B., Yao, R., & Zhu, Y. (2023). Effect of dexmedetomidine on posttraumatic stress disorder in patients undergoing emergency trauma surgery: A randomized clinical trial. JAMA Network Open, 6(6), e2318611. https://doi.org/10.1001/jamanetworkopen.2023.18611