ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital of Fudan University, Shanghai, People's Republic of China.
Shanghai Municipal Key Clinical Specialty, Eye & ENT Hospital of Fudan University, Shanghai, People's Republic of China.
Drug Des Devel Ther. 2023 Jun 2;17:1631-1640. doi: 10.2147/DDDT.S413321. eCollection 2023.
To examine whether nighttime dexmedetomidine infusion improved sleep quality in patients after laryngectomy.
Thirty-five post-laryngectomy patients admitted to the intensive care unit (ICU) were randomly assigned to a 9-h (from 2100 h on surgery day to 0600 h the morning after laryngectomy) dexmedetomidine (0.3 μg/kg/h continuous infusion) or placebo group. Polysomnography results were monitored during the dexmedetomidine infusion period. The percentage of stage 2 non-rapid eye movement (stage N2) sleep was the primary outcome measure.
Thirty-five patients (18 placebo group; 17 dexmedetomidine group) had complete polysomnogram recordings. The percentage of stage N3 sleep was significantly increased in the dexmedetomidine infusion group (from median 0% (0 to 0) in placebo group to 0% (interquartile range, 0 to 4) in dexmedetomidine group (difference, -2.32%; 95% CI, -4.19 to -0.443; P = 0.0167)). Infusion had no effect on total sleep time, stage N1 or N2 sleep percentages, or sleep efficiency. It decreased muscle tensity and snore non-rapid eye movement. Subjective sleep quality improved. Hypotension incidence increased in the dexmedetomidine group, but significant intervention was not required.
Dexmedetomidine infusion improved overall patient sleep quality in the ICU after laryngectomy.
研究喉切除术后患者夜间输注右美托咪定是否能改善睡眠质量。
35 例入住重症监护病房（ICU）的喉切除术后患者随机分为右美托咪定（0.3μg/kg/h 持续输注）组或安慰剂组，输注时长 9 小时（从手术当天 21:00 至喉切除术后次日 06:00）。在右美托咪定输注期间监测多导睡眠图结果。次要观察指标为非快速动眼睡眠（N2）睡眠的百分比。
35 例患者（18 例安慰剂组；17 例右美托咪定组）完成了多导睡眠图记录。右美托咪定输注组 N3 睡眠的百分比显著增加（安慰剂组中位数为 0%（0 至 0），右美托咪定组为 0%（四分位距，0 至 4）（差异，-2.32%；95%CI，-4.19 至-0.443；P=0.0167））。输注对总睡眠时间、N1 或 N2 睡眠百分比或睡眠效率均无影响。它降低了肌肉张力和鼾声非快速动眼睡眠。主观睡眠质量改善。右美托咪定组低血压的发生率增加，但不需要进行显著干预。
喉切除术后 ICU 患者中，右美托咪定输注可改善整体睡眠质量。
