Journal Publication

Post-op dexmedetomidine nasal spray improves sleep, not anxiety, after laparoscopy

A randomized trial found a second nighttime dose of dexmedetomidine nasal spray preserved sleep architecture and shortened hospital stay, but did not separate from control on next-day insomnia scores.

By AppliedXLJuly 15, 2026

Executive Summary

A randomized trial asked whether adding a second, nighttime dose of dexmedetomidine nasal spray on top of the standard preoperative dose could further protect anxiety and sleep after gynecological laparoscopic surgery.
The added dose did not lower overall insomnia scores compared with a single preoperative dose alone, but it preserved deeper, less fragmented sleep and shortened time in the hospital afterward.
The findings point toward objective sleep architecture and length of stay, not a global anxiety or insomnia score, as the more sensitive way to detect a benefit from perioperative dexmedetomidine dosing.
A single-center trial of 80 patients establishes a pattern worth testing further rather than a change to standard perioperative practice.

The stake

Postoperative sleep disturbance is common after gynecological laparoscopic surgery and can delay recovery. Many surgical centers already give a preoperative dose of dexmedetomidine hydrochloride nasal spray, a sedative alpha-2 agonist delivered intranasally, to reduce preoperative anxiety. The open question this trial addressed was whether a second dose, given the night after surgery, could extend that benefit into the postoperative period, when disrupted sleep is most likely to interfere with recovery. Effect

How it was done

The study was a prospective, single-blind, randomized, controlled trial run at a single center, enrolling 80 patients scheduled for elective gynecological laparoscopic surgery between June 2024 and December 2024. All 80 received 50 micrograms of dexmedetomidine nasal spray 30 minutes before anesthesia; 40 were randomized to receive an additional 75 micrograms at 9:30 PM on the night of surgery, while the other 40 received no additional dose. Anxiety was measured with the Hamilton Anxiety Scale and sleep with the Athens Insomnia Scale plus wearable sleep-tracking wristbands. Effect

The results

Baseline characteristics, postoperative pain, and nausea and vomiting were similar between the two groups (all P>0.05), and both groups showed a drop in Hamilton Anxiety Scale scores after the preoperative dose compared with baseline (both P<0.001). On the trial's primary sleep measure, total Athens Insomnia Scale score on the night of surgery, the added dose showed no difference from control (P=0.771). On the secondary, objective measures, the added-dose group had a higher share of patients without subjective sleep deterioration (25.0% versus 5.0%, P=0.012), longer total sleep time (P=0.030), a higher proportion of deep sleep (P=0.040), and fewer awakenings (P=0.020). Effect

Recovery signal

The added-dose group also had a shorter postoperative hospital stay than controls (P<0.001). That result sits alongside the sleep-architecture findings rather than the flat primary insomnia score, and together the two point to the objective, wristband-measured sleep data as the more sensitive marker of benefit than the total insomnia questionnaire score in this population. The authors reported no increase in adverse reactions with the additional dose. Effect

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