Dexmedetomidine improves early quality of recovery but not reduce risk of chronic postsurgical pain after intraoperative neuromonitoring thyroidectomy, a randomized trail.

Neuromonitoring thyroidectomy minimizes nerve injury but patients suffer poor postoperative quality of recovery. We hypothesize that dexmedetomidine enhance recovery quality and reduce chronic postsurgical pain (CPSP) after thyroidectomy. In this randomized-controlled trial, 60 patients undergoing neuromonitoring thyroidectomy were randomized into two groups. 30 patients received dexmedetomidine 0.6 µg.kg ^− 1 before induction (Group D).The rest received saline as placebo (Group C). The primary endpoint is the global QoR40 score on postoperative day 1 (POD1). The secondary endpoints included QoR40 scores on POD3, intraoperative hemodynamic parameters, time from desflurane discontinued to verbal response and extubation, postoperative adverse events, hospital stay and expense, and Incidence of CPSP. Global QoR40 scores on POD1 and POD3 were significantly higher in Group D than Group C (POD1: 177.93 ± 9.41 vs 159.34 ± 17.91; POD3: 184.67 ± 9.86 vs 175.90 ± 12.37, P < 0.05). Compared to Group C, there were less patients receiving palonosetron to treat postoperative nausea and vomiting and flurbiprofens for postoperative pain management in Group D ( P  < 0.05). The occurrence of CPSP was similar between groups. We conclude that intraoperative dexmedetomidine improves the quality of recovery and alleviates PONV and postoperative pain in patients after neuromonitoring thyroidectomy without effectiveness in preventing CPSP.