Ke et al. BMC Anesthesiology (2023) 23:110 https://doi.org/10.1186/s12871-023-02032-0 RESEARCH Open Access © The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativeco mmons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. BMC Anesthesiology Opioid-sparing anesthesia with dexmedetomidine provides stable hemodynamic and short hospital stay in non-intubated video-assisted thoracoscopic surgery: a propensity score matching cohort study Hui‑Hsuan Ke 1,2 , Jing‑Yang Liou 1,2 , Wei‑Nung Teng 1,2 , Po‑Kuei Hsu 1,3 , Mei‑Yung Tsou 1,2 , Wen‑Kuei Chang 1,2 and Chien‑Kun Ting 1,2* Abstract Objectives Dexmedetomidine is an alpha‑2 agonist with anti‑anxiety, sedative, and analgesic efects and causes a lesser degree of respiratory depression. We hypothesized that the use of dexmedetomidine in non‑intubated video‑assisted thoracic surgery (VATS) may reduce opioid‑related complications such as postoperative nausea and vomiting (PONV), dyspnea, constipation, dizziness, skin itching, and cause minimal respiratory depression, and stable hemodynamic status. Methods Patients who underwent non‑intubated VATS lung wedge resection with propofol combined with dexmedetomidine (group D) or alfentanil (group O) between December 2016 and May 2022 were enrolled in this retrospective propensity score matching cohort study. Intraoperative vital signs, arterial blood gas data, perioperative results and treatment outcomes were analyzed. Of 100 patients included in the study (group D, 50 and group O, 50 patients), group D had a signifcantly lower degree of decrement in the heart rate and the blood pressure than group O. Intraoperative one‑lung arterial blood gas revealed lower pH and signifcant ETCO 2 . The common opioid‑related side efects, including PONV, dyspnea, constipa‑ tion, dizziness, and skin itching, all of which occurred more frequently in group O than in group D. Patients in group O had signifcantly longer postoperative hospital stay and total hospital stay than group D, which might be due to opioid‑related side efects postoperatively. Conclusions The application of dexmedetomidine in non‑intubated VATS resulted in a signifcant reduction in perioperative opioid‑related complications and maintenance with acceptable hemodynamic performance. These clinical outcomes found in our retrospective study may enhance patient satisfaction and shorten the hospital stay. *Correspondence: Chien‑Kun Ting ckting2@gmail.com Full list of author information is available at the end of the article