改善术后睡眠:我们能做些什么?
Improve postoperative sleep: what can we do?
作者信息
Su Xian, Wang Dong-Xin
机构信息
Department of Anesthesiology and Critical Care Medicine, Peking University First Hospital, Beijing, China.
出版信息
Curr Opin Anaesthesiol. 2018 Feb;31(1):83-88. doi: 10.1097/ACO.0000000000000538.
PURPOSE OF REVIEW
We reviewed evidences regarding occurrence, risk factors, harmful effects, prevention, and management of sleep disturbances in patients after surgery.
RECENT FINDINGS
Normal sleep is important to maintain physical and mental health. Sleep disturbances frequently occur in patients after surgery. Factors associated with the development of postoperative sleep disturbances include old age, preoperative comorbidity, type of anesthesia, severity of surgical trauma, postoperative pain, environment stress, as well as other factors leading to discomfort of patients. Development of sleep disturbances produces harmful effects on postoperative patients, that is, leading to higher risk of delirium, increased sensitivity to pain, more cardiovascular events, and poorer recovery. Both nonpharmacological and pharmacological measures (such as zolpidem, melatonin, and dexmedetomidine) can be used to improve postoperative sleep. Recent evidences show that sleep promotion may improve patients' outcome, but requires further evidences.
SUMMARY
Sleep disturbances are common in patients after surgery and produce harmful effects on postoperative recovery. Sleep-promotion therapy may be helpful to improve postoperative recovery, but long-term effects deserve further study.
综述目的
我们回顾了有关术后患者睡眠障碍的发生、危险因素、有害影响、预防及管理的证据。
最新发现
正常睡眠对维持身心健康很重要。睡眠障碍在术后患者中频繁发生。与术后睡眠障碍发生相关的因素包括老年、术前合并症、麻醉类型、手术创伤严重程度、术后疼痛、环境压力以及导致患者不适的其他因素。睡眠障碍的发生对术后患者产生有害影响,即导致谵妄风险更高、对疼痛更敏感、心血管事件增多以及恢复较差。非药物和药物措施(如唑吡坦、褪黑素和右美托咪定)均可用于改善术后睡眠。最新证据表明促进睡眠可能改善患者预后,但仍需更多证据。
总结
睡眠障碍在术后患者中很常见,并对术后恢复产生有害影响。促进睡眠疗法可能有助于改善术后恢复,但其长期效果值得进一步研究。