Wang Lin, Liang Xin-Quan, Sun Yan-Xia, Hua Zhen, Wang Dong-Xin
Department of Anesthesiology, Peking University First Hospital, Beijing, China.
Department of Anesthesiology, Beijing Hospital, National Center of Gerontology, Beijing, China.
PLoS One. 2024 Dec 5;19(12):e0314814. doi: 10.1371/journal.pone.0314814. eCollection 2024.
Dexmedetomidine may improve sleep quality after surgery, but conflicting results also exist. Herein, we explored the effects of perioperative dexmedetomidine on postoperative sleep quality in adult patients.
In this systematic review and meta-analysis, randomized controlled trials investigating the effects of perioperative dexmedetomidine on sleep quality after noncardiac surgery were retrieved from Cochrane Library, PubMed, and EMBASE from inception to January 12, 2023, and updated on March 15, 2024. The Cochrane Collaboration's tool was applied to assess risk of bias. A random-effects model was used for meta-analysis. The primary outcome was the subjective sleep quality score on the first night after surgery.
A total of 29 trials containing 5610 participants were included. The subjective sleep score on the first postoperative night was lower (better) with dexmedetomidine than with placebo (SMD [standardized mean difference] = -0.8, 95% CI -1.1 to -0.6, p<0.00001; I2 = 93%; 22 trials; n = 4611). Sensitivity analysis showed that overall conclusion was not changed (SMD = -0.8, 95% CI -1.1 to -0.5, p<0.00001; I2 = 93%; 14 trials; n = 3846). Results of polysomnographic monitoring showed improved sleep structure with dexmedetomidine on the first night after surgery, as manifested by increased sleep efficiency index and stage N2 sleep and decreased arousal index and stage N1 sleep.
This systematic review suggests that, among patients who underwent noncardiac surgery, perioperative dexmedetomidine administration may improve early postoperative sleep quality pattern. However, the resulting evidence were of low or very low qualities and further studies are required to confirm our results.
CRD42023390972.
右美托咪定可能改善术后睡眠质量，但也存在相互矛盾的结果。在此，我们探讨了围手术期使用右美托咪定对成年患者术后睡眠质量的影响。
在这项系统评价和荟萃分析中，从Cochrane图书馆、PubMed和EMBASE数据库中检索了自数据库建立至2023年1月12日，以及2024年3月15日更新的关于围手术期右美托咪定对非心脏手术后睡眠质量影响的随机对照试验。应用Cochrane协作网的工具评估偏倚风险。采用随机效应模型进行荟萃分析。主要结局是术后第一晚的主观睡眠质量评分。
共纳入29项试验，5610名参与者。与安慰剂相比，右美托咪定组术后第一晚的主观睡眠评分更低（更好）（标准化均数差[SMD]= -0.8，95%CI -1.1至-0.6，p<0.00001；I2 = 93%；22项试验；n = 4611）。敏感性分析表明总体结论未改变（SMD = -0.8，95%CI -1.1至-0.5，p<0.00001；I2 = 93%；14项试验；n = 3846）。多导睡眠图监测结果显示，术后第一晚使用右美托咪定可改善睡眠结构，表现为睡眠效率指数和N2期睡眠增加，觉醒指数和N1期睡眠减少。
这项系统评价表明，在接受非心脏手术的患者中，围手术期使用右美托咪定可能改善术后早期睡眠质量模式。然而，所得证据质量低或非常低，需要进一步研究来证实我们的结果。
PROSPERO注册号：CRD42023390972。
