Clinical Research Directory

Inclusion Criteria: * Age ≥18 years. * Underwent elective bronchoscopic procedures (diagnostic or therapeutic) under general anesthesia. * Airway managed with an endotracheal tube or a supraglottic airway device. * For patients who underwent multiple eligible procedures during the study period, only the first procedure was included. Exclusion Criteria: * Persistent preoperative sore throat, hoarseness, dysphagia, or foreign body sensation in the throat. * Active pharyngeal or laryngeal infection or inflammatory disease, including acute pharyngitis, acute laryngitis, and acute tonsillitis. * Conditions significantly affecting pharyngolaryngeal structure or function, including vocal cord paralysis, laryngeal stenosis, active laryngeal edema, and active tumors involving the pharynx or larynx. * History of pharyngeal, laryngeal, nasal, or paranasal sinus surgery. * Superior vena cava syndrome accompanied by clear upper airway edema, compression, or related pharyngolaryngeal symptoms. * Severe nasal obstruction, active epistaxis, or nasal disease or condition with obvious nasal mucosal injury before surgery. * Pregnancy or lactation. * Known history of allergy to dexmedetomidine or to components of the nasal spray formulation. * High-grade or complete atrioventricular block without an effective pacemaker. * Preoperative marked bradycardia (resting heart rate \<50 beats/min), severe hypotension (systolic blood pressure \<90 mmHg), hemodynamic instability, or severe cardiovascular disease with decompensated heart failure. * Severe hepatic failure, including acute liver failure, acute-on-chronic liver failure, or Child-Pugh class C hepatic dysfunction. * Severe renal failure, including chronic kidney disease stage G5, end-stage renal disease on long-term dialysis, or preoperative KDIGO stage 3 acute kidney injury.