Li Shiyi, Song Bijia, Li Yang, Zhu Junchao
Department of Anesthesiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, People's Republic of China.
Department of Anesthesiology, Beijing Friendship Hospital of Capital Medical University, Beijing, People's Republic of China.
Nat Sci Sleep. 2021 Mar 15;13:375-382. doi: 10.2147/NSS.S300803. eCollection 2021.
Decreased postoperative sleep quality remains a serious problem in surgical settings at present. The purpose of our study was to compare the effect of propofol vs sevoflurane on early postoperative sleep quality and complications of patients receiving laparoscopic surgery after general anesthesia.
Seventy-four patients undergoing selective laparoscopic surgery under general anesthesia were randomly assigned to the propofol group or sevoflurane group. The wireless portable sleep monitor (WPSM) is used to collect sleep quality on the night before surgery (sleep preop 1), the first night after surgery (sleep POD 1), and the third night after surgery (sleep POD 3). Record the subjective sleep quality and dreaming state during the operation. The perioperative hemodynamics, postoperative sleep and complications were also evaluated.
Compared with Sleep preop 1, patients showed lower sleep efficiency, Stable sleep and Unstable sleep during Sleep POD 1 and Sleep POD 3. In addition, compared with the propofol group, the proportion of REM sleep in the sevoflurane group was much higher during Sleep POD 1 and Sleep POD 3, and the incidence of dreaming was also higher in the sevoflurane group. Patients in the propofol group had better pain relief at 2, 4, and 6 hours after surgery. And the incidence of postoperative nausea and vomiting and dizziness in the sevoflurane group was significantly higher than that in the propofol group.
The degree of postoperative sleep efficiency was better on Sleep POD1 and Sleep POD3; the incidence of postoperative nausea and vomiting, and dizziness was lower; and postoperative pain was slighter when the operation was performed under propofol anesthesia compared with patients in the sevoflurane group. Propofol should be considered a better choice during the operation to promote the patient's postoperative sleep quality, relieve postoperative pain and improve the incidence of postoperative dizziness and nausea and vomiting.
目前,术后睡眠质量下降仍是外科手术环境中的一个严重问题。我们研究的目的是比较丙泊酚与七氟醚对全身麻醉后接受腹腔镜手术患者术后早期睡眠质量及并发症的影响。
74例接受全身麻醉下选择性腹腔镜手术的患者被随机分配至丙泊酚组或七氟醚组。使用无线便携式睡眠监测仪(WPSM)在手术前一晚(术前睡眠1)、术后第一晚(术后第1天睡眠)和术后第三晚(术后第3天睡眠)收集睡眠质量。记录手术期间的主观睡眠质量和梦境状态。还评估围手术期血流动力学、术后睡眠及并发症情况。
与术前睡眠1相比,患者在术后第1天睡眠和术后第3天睡眠时睡眠效率较低,睡眠稳定和不稳定情况出现。此外,与丙泊酚组相比,七氟醚组在术后第1天睡眠和术后第3天睡眠时快速眼动睡眠比例更高,且七氟醚组梦境发生率也更高。丙泊酚组患者在术后2、4和6小时疼痛缓解情况更好。七氟醚组术后恶心呕吐和头晕的发生率明显高于丙泊酚组。
与七氟醚组患者相比,丙泊酚麻醉下手术时,术后第1天睡眠和术后第3天睡眠时睡眠效率更高;术后恶心呕吐和头晕的发生率更低;术后疼痛更轻。丙泊酚应被视为手术期间促进患者术后睡眠质量、缓解术后疼痛以及改善术后头晕和恶心呕吐发生率的更好选择。