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围手术期使用右美托咪定改善手术患者术后睡眠质量的研究进展。

Advances in the use of dexmedetomidine during the perioperative period to improve postoperative sleep quality in patients undergoing surgery.

机构信息

The First School of Clinical Medicine, Lanzhou University, Lanzhou Gansu, China.

Department of Anesthesiology and Surgery, First Hospital of Lanzhou University, Lanzhou Gansu, China.

出版信息

J Int Med Res. 2024 Nov;52(11):3000605241290715. doi: 10.1177/03000605241290715.

Abstract

There is a high incidence of postoperative sleep and sleep architecture disorders in patients undergoing surgery, and dexmedetomidine (DEX) is commonly used to improve postoperative sleep quality and ameliorate the adverse effects of poor sleep on various organ systems. The continuous intraoperative intravenous infusion of DEX, the addition of DEX to postoperative intravenous analgesia pumps, and the continuous infusion of DEX after admission to the intensive care unit are often used clinically to improve postoperative sleep quality at doses of 0.1 to 0.7 μg/kg/hour, but the effects of DEX on sleep quality and structure identified in these studies have been inconsistent. Thus, it is unclear whether DEX improves postoperative sleep quality. The various methods of administering DEX to improve postoperative sleep quality have differing effects, the route used modifies the effect of DEX on sleep structure, and the intrinsic mechanism whereby DEX improves sleep quality remains to be fully investigated. In the present review, we describe new directions for future research into the effects of DEX on postoperative sleep quality and the mechanisms involved, which should help guide the design of further studies. This narrative review was completed according to the Scale for the Assessment of Narrative Review Articles (SANRA).

摘要

术后患者睡眠和睡眠结构障碍的发生率较高,临床常使用右美托咪定(DEX)改善术后睡眠质量,减轻睡眠不良对各器官系统的不良影响。DEX 术中持续静脉输注、DEX 加入术后静脉镇痛泵、入住重症监护病房后持续输注,常以 0.1 至 0.7μg/kg/h 的剂量用于改善术后睡眠质量,但这些研究中 DEX 对睡眠质量和结构的影响并不一致。因此,DEX 是否能改善术后睡眠质量尚不清楚。DEX 改善术后睡眠质量的各种给药方式效果不同,用药途径改变了 DEX 对睡眠结构的影响,DEX 改善睡眠质量的内在机制仍有待充分研究。本综述描述了 DEX 对术后睡眠质量影响及相关机制的未来研究新方向,这有助于指导进一步研究的设计。本综述按照叙事性综述评估工具(SANRA)进行撰写。

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