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日间手术与夜间手术中术中使用右美托咪定对全身麻醉下术后睡眠质量和疼痛的影响

The Effect Of Intraoperative Use Of Dexmedetomidine During The Daytime Operation Vs The Nighttime Operation On Postoperative Sleep Quality And Pain Under General Anesthesia.

作者信息

Song Bijia, Li Yang, Teng Xiufei, Li Xiuyan, Yang Yanchao, Zhu Junchao

机构信息

Department of Anesthesiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, People's Republic of China.

出版信息

Nat Sci Sleep. 2019 Oct 3;11:207-215. doi: 10.2147/NSS.S225041. eCollection 2019.

Abstract

OBJECTIVES

The aim of our study was to compare the effect of using dexmedetomidine (DEX) during the daytime operation or the nighttime operation under general anesthesia on postoperative sleep quality and pain of patients.

METHODS

Seventy-five patients scheduled for elective laparoscopic abdominal surgeries under general anesthesia were randomly assigned to receive operation in the Day Group (8:00-12:00) and the Night Group (18:00-22:00). The Portable Sleep Monitor (PSM) was performed on the following 3 nights: the night before surgery (Sleep 1), the first night after surgery (Sleep 2), and the third night after surgery (Sleep 3). Postoperative pain scores using visual analogue scoring scale, subjective sleep quality using the Athens Insomnia Scale, total dose of general anesthetics and PCA pump press numbers were also recorded.

RESULTS

Intraoperative administration of DEX for patients in the Day Group could improve sleep quality with a higher sleep efficiency and a lower AIS subjective sleep quality than patients in the Night Group at Sleep 2 (P < 0.001 and P = 0.001, respectively) and Sleep 3 (P < 0.001, respectively). There were marked lower rapid eye movement (REM) sleep and Stable sleep in the Night Group than that in the Day Group at Sleep 2 (P < 0.001 and P = 0.032, respectively) and Sleep 3 (P < 0.001, respectively). Patients in the Day Group have better pain relief and less PCA pump press numbers than patients in the Night Group.

CONCLUSION

Using dexmedetomidine during the daytime operation can better improve postoperative sleep quality and pain than nighttime operation in patients undergoing laparoscopic abdominal surgeries.

摘要

目的

本研究旨在比较全身麻醉下日间手术或夜间手术使用右美托咪定(DEX)对患者术后睡眠质量和疼痛的影响。

方法

75例计划行全身麻醉下择期腹腔镜腹部手术的患者被随机分配至日间组(8:00 - 12:00)和夜间组(18:00 - 22:00)接受手术。在术后接下来的3个晚上使用便携式睡眠监测仪(PSM)进行监测:手术前一晚(睡眠1)、术后第一晚(睡眠2)和术后第三晚(睡眠3)。还记录了使用视觉模拟评分量表的术后疼痛评分、使用雅典失眠量表的主观睡眠质量、全身麻醉药的总剂量和PCA泵按压次数。

结果

日间组患者术中使用DEX,在睡眠2(分别为P < 0.001和P = 0.001)和睡眠3(分别为P < 0.001)时,与夜间组患者相比,睡眠效率更高,AIS主观睡眠质量更低,可改善睡眠质量。在睡眠2(分别为P < 0.001和P = 0.032)和睡眠3(分别为P < 0.001)时,夜间组的快速眼动(REM)睡眠和稳定睡眠明显低于日间组。日间组患者比夜间组患者疼痛缓解更好,PCA泵按压次数更少。

结论

在接受腹腔镜腹部手术的患者中,日间手术使用右美托咪定比夜间手术能更好地改善术后睡眠质量和疼痛。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b92a/6783397/dd3956c14e0d/NSS-11-207-g0001.jpg

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