Department of Dermatology, Seoul National University College of Medicine, Seoul, South Korea.
Institute of Human-Environment Interface Biology, Seoul National University, Seoul, South Korea.
Dermatol Ther. 2020 Nov;33(6):e14535. doi: 10.1111/dth.14535. Epub 2020 Nov 22.
Mohs micrographic surgery (MMS) is a highly specialized technique for treating skin cancer. Drawbacks of MMS are the multi-step procedure and long surgery time. Some patients sleep during surgery and involuntary movements during sleeping can interfere with surgery, which increases the risk of a fall injury. However, to our knowledge, there have been no studies regarding the characteristics of patients' sleep during MMS. This study aimed to investigate the prevalence and characteristics of sleeping patients during MMS. We performed a prospective study and included patients with skin cancers impending MMS. All patients rated their anxiety levels and sleep status using the State-Trait Anxiety Inventory, an anxiety visual analog scale, the Pittsburgh Sleep Quality Index, and the Leeds Sleep Evaluation Questionnaire. Our data showed that 21.9% of patients were asleep during MMS. Multivariable analysis showed that older age (odds ratio [OR], 1.142; p=0.003), lesion size >150 mm (OR, 7.904; p=0.031), and multi-stage MMS (OR, 12.201; p=0.011) were significantly associated factors of sleep. This study is the first to report the prevalence and associated factors of sleep during MMS. Physicians should monitor patients with risk factors during MMS to prevent possible medical accidents.
Mohs 显微外科手术（MMS）是治疗皮肤癌的一种高度专业化技术。MMS 的缺点是多步骤程序和较长的手术时间。一些患者在手术过程中会入睡，而睡眠期间的无意识运动可能会干扰手术，增加跌倒受伤的风险。然而，据我们所知，目前还没有关于 MMS 期间患者睡眠特征的研究。本研究旨在调查 MMS 期间患者入睡的发生率和特征。我们进行了一项前瞻性研究，纳入了即将接受 MMS 治疗的皮肤癌患者。所有患者均使用状态-特质焦虑量表、焦虑视觉模拟量表、匹兹堡睡眠质量指数和利兹睡眠评估问卷评估他们的焦虑水平和睡眠状况。我们的数据显示，21.9%的患者在 MMS 期间入睡。多变量分析显示，年龄较大（比值比 [OR]，1.142；p=0.003）、病变大小>150 mm（OR，7.904；p=0.031）和多阶段 MMS（OR，12.201；p=0.011）是睡眠的显著相关因素。这项研究首次报告了 MMS 期间睡眠的发生率和相关因素。医生在 MMS 期间应监测有风险因素的患者，以防止可能发生的医疗事故。
