The Impact of Dexmedetomidine Nasal Spray on Perioperative Anxiety in Neurosurgical Patients

Inclusion Criteria: * American Society of Anesthesiologists physical status I to III * Scheduled to undergo elective supratentorial tumor resection * Preoperative STAI-S score \>45 * Obtain written informed consent Exclusion Criteria: * Severe hepatic or renal insufficiency * Allergy to dexmedetomidine or its excipients * Severe bradycardia (heart rate \<50 bpm), sick sinus syndrome, or second-/third-degree AV block without pacemaker * Use of α2-agonists, benzodiazepines, or other sedatives/analgesics within 24 hours preoperatively * History of alcohol, drug, or psychoactive substance dependence * Diagnosed or suspected obstructive sleep apnea syndrome * Nasal anatomical abnormalities, acute rhinitis, epistaxis, or other nasal conditions affecting drug administration * Pregnancy or lactation * Communication barriers, psychiatric disorders, or cognitive impairment precluding scale completion * Visual/hearing impairment or inability to read