Department of Medical Records Room, Affiliated Hospital of Youjiang Medical University for Nationalities, Baise City, Guangxi, 533000, China.
Department of Anesthesia, Guangxi Baise Pingguo Aluminum Hospital, Baise City, Guangxi, 533000, China.
Crit Rev Immunol. 2024;44(6):63-73. doi: 10.1615/CritRevImmunol.2024051294.
Postoperative sleep disturbance is a common issue that affects recovery in patients undergoing general anesthesia. Dexmedetomidine (Dex) has a potential role in improving postoperative sleep quality. We evaluated the effects of different doses of Dex on postoperative sleep disturbance and serum neurotransmitters in patients undergoing radical gastrectomy under general anesthesia. Patients were assigned to the control, NS, and Dex (Dex-L/M/H) groups based on different treatment doses [0.2, 0.4, and 0.6 μg/(kg · h)]. The Athens Insomnia Scale (AIS) and ELISA kits were used to assess sleep disturbance and serum neurotransmitter (GABA, 5-HT, NE) levels before surgery and on postoperative days one, four, and seven. The effects of different doses on postoperative sleep disturbance incidence and serum neurotransmitter levels were analyzed by the Fisher exact test and one-way and repeated-measures ANOVA. Patients had no differences in gender, age, body mass index, operation time, and bleeding volume. Different Dex doses reduced the postoperative AIS score of patients under general anesthesia, improved their sleep, and increased serum levels of 5-HT, NE, and GABA. Furthermore, the effects were dose-dependent within the range of safe clinical use. Specifically, Dex at doses of 0.2, 0.4, and 0.6 μg/(kg · h) reduced postoperative AIS score, elevated serum neurotransmitter levels, and reduced postoperative sleep disturbance incidence. Collectively, Dex has a potential preventive effect on postoperative sleep disturbance in patients undergoing general anesthesia for radical gastrectomy. The optimal dose of Dex is between 0.2 and 0.6 μg/(kg · h), which significantly reduces the incidence of postoperative sleep disturbance and increases serum neurotransmitter levels.
术后睡眠障碍是影响全麻患者康复的常见问题。右美托咪定（Dex）在改善术后睡眠质量方面具有潜在作用。我们评估了不同剂量 Dex 对全麻下行根治性胃切除术患者术后睡眠障碍及血清神经递质的影响。患者根据不同治疗剂量（0.2、0.4 和 0.6μg/（kg·h））分为对照组、NS 组和 Dex（Dex-L/M/H）组。采用 Athens 失眠量表（AIS）和 ELISA 试剂盒评估术前及术后第 1、4、7 天睡眠障碍和血清神经递质（GABA、5-HT、NE）水平。采用 Fisher 确切检验和单向及重复测量方差分析不同剂量对术后睡眠障碍发生率及血清神经递质水平的影响。患者的性别、年龄、体重指数、手术时间和出血量无差异。不同 Dex 剂量可降低全麻患者术后 AIS 评分，改善睡眠，增加血清 5-HT、NE 和 GABA 水平，且在安全临床使用范围内呈剂量依赖性。具体而言，Dex 剂量为 0.2、0.4 和 0.6μg/（kg·h）时可降低术后 AIS 评分，升高血清神经递质水平，降低术后睡眠障碍发生率。综上，Dex 对全麻下行根治性胃切除术患者术后睡眠障碍具有潜在预防作用，其最佳剂量为 0.2~0.6μg/（kg·h），可显著降低术后睡眠障碍发生率，增加血清神经递质水平。
