What question did this study set out to answer?

This trial aims to evaluate the efficacy of dexmedetomidine in reducing postoperative delirium in patients with obstructive sleep apnea.

May 20, 2026Open Access

The impact of dexmedetomidine on postoperative delirium in obstructive sleep apnea patients (DPOD-OSA): study protocol for a prospective randomized controlled trial

Key Points

This trial aims to evaluate the efficacy of dexmedetomidine in reducing postoperative delirium in patients with obstructive sleep apnea.
Prospective randomized controlled trial with three treatment groups: high dose, low dose, and control.
Patients screened for obstructive sleep apnea using STOP-Bang questionnaire with those at risk undergoing further monitoring.
Postoperative delirium assessed using Confusion Assessment Methods for up to 7 days.
Primary outcome: occurrence of postoperative delirium assessed across all treatment groups.
Secondary outcomes include pain levels, length of stay, and postoperative complications.

Abstract

BACKGROUND: Recent studies suggest that patients at intermediate-high risk of obstructive sleep apnea (OSA) are at greater risk of developing postoperative delirium (POD). The administration of dexmedetomidine (DEX) is suggested to prevent POD in the normal population. However, few studies have investigated the impact of DEX on POD in OSA patients. METHODS/DESIGN: A prospective, randomized controlled trial will be conducted at a single center. Patients scheduled for elective laparoscopic surgery will be screened with the STOP-Bang questionnaire (SBQ). Patients who are intermediate-high risk for OSA (SBQ score ≥ 3) will be suggested to take a portable monitoring device for the diagnosis of OSA. Apner-Hyponea Index (AHI) values > 5/h are considered OSA. All the recruited OSA patients are randomly assigned to three treatment groups. The high dose of DEX group was treated with DEX at a loading dose of 0.5 μg/kg over 10 min followed by a maintenance dose of 0.2~0.7 μg/kg/h. The low dose of DEX group was treated with DEX at a maintenance dose of 0.5 μg/kg/h. The control group was not treated with DEX. POD was assessed using the 3-min diagnostic Confusion Assessment Method (3D-CAM) or the Confusion Assessment Method for Intensive Care Unit (CAM-ICU) for 7 consecutive days or until discharge. We used the Richmond Agitation and Sedation Scale (RASS) to assess the level of sedation and drowsiness. The primary outcome will be the occurrence of POD. The secondary outcomes include pain at rest and provoked pain during postoperative day 1-7, length of stay (LOS) and postoperative complications within 30 days. DISCUSSION: The result of this study will demonstrate whether the application of DEX could reduce the incidence of POD in OSA patients. We are of the conviction that the outcomes of this trial will afford a highly efficacious modality for preventing the occurrence of POD. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR2500108088. Registered on 25 August 2025.

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