Wang Hongyu, Luo Man, Yang Yanping, Li Shiyi, Liang Song, Xu Ran, Zhu Junchao, Song Bijia
Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
Department of Thoracic Surgery, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.
Heliyon. 2024 Oct 5;10(19):e39015. doi: 10.1016/j.heliyon.2024.e39015. eCollection 2024 Oct 15.
The purpose of our study was to investigate the effect of gender on postoperative pain, sleep quality, and recovery outcomes in patients undergoing VATS surgery under general anesthesia.
Perioperative peripheral blood inflammatory markers system inflammation Index (SII) was recorded for perioperative inflammatory response. The visual analog scale (VAS) was used to evaluate pain level. And the Athens Insomnia Scale (AIS) was evaluated 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) for postoperative sleep.
In this prospective cohort study, 79 males and 79 females were consecutively included. Females had significantly higher pain score (both rest and cough pain) compared to the males at 3 h after the surgery (3.85 ± 1.2 vs. 3.16 ± 1.1) (rest) (p < 0.001) and 5.10 ± 1.3 vs. 4.46 ± 1.6 (coughing) (p = 0.006)). Patients in the male group had significantly lower AIS scores than those in the female group at Sleep POD 1 and Sleep POD 3 (p = 0.024 and p = 0.045). And in both groups, postoperative SII was increased and statistically significant compared to preoperative SII (p < 0.001, respectively). Women presented higher levels of SII on the first day after surgery, and the increase of postoperative SII in females groups was significantly higher than that in male group when compared to preoperative SII (1806.33 ± 1314.8 vs 1430.55 ± 958.4) (p = 0.042).
These findings highlight the complex multidimensional nature of postoperative pain, nausea and vomiting, sleep quality and the potential contributory role of sex in shaping these outcomes. Women had worse sleep quality, higher postoperative inflammatory response level and pain level than men.
本研究旨在探讨性别对全身麻醉下行电视辅助胸腔镜手术（VATS）患者术后疼痛、睡眠质量及恢复结果的影响。
记录围手术期外周血炎症标志物系统炎症指数（SII）以评估围手术期炎症反应。采用视觉模拟量表（VAS）评估疼痛程度。并在手术前一晚（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）使用雅典失眠量表（AIS）评估术后睡眠情况。
在这项前瞻性队列研究中，连续纳入了79名男性和79名女性。与男性相比，女性在术后3小时的疼痛评分（静息和咳嗽疼痛）显著更高（静息时：3.85±1.2 vs. 3.16±1.1）（p<0.001），咳嗽时：5.10±1.3 vs. 4.46±1.6（p = 0.006）。在术后第1天睡眠和术后第3天睡眠时，男性组的AIS评分显著低于女性组（p = 0.024和p = 0.045）。并且在两组中，术后SII均较术前升高且具有统计学意义（分别为p<0.001）。女性在术后第一天的SII水平更高，与术前SII相比，女性组术后SII的升高显著高于男性组（1806.33±1314.8 vs 1430.55±958.4）（p = 0.042）。
这些发现突出了术后疼痛、恶心和呕吐、睡眠质量的复杂多维度性质以及性别在塑造这些结果中的潜在作用。女性的睡眠质量更差，术后炎症反应水平和疼痛程度高于男性。
