Wang Cha, Tao Keji, An Xiujun, Gu Jinye, Chen Junping, Sun Jianliang, Li Xiaoyu, Lu Bo
Department of Anesthesiology, Ningbo No.2 Hospital, No.41, Northwest Street, Ningbo, Zhejiang Province, 315000, China.
Department of Anesthesiology, Ninghai Maternal and Child Health Hospital, Ningbo, 315600, China.
Sci Rep. 2025 Jul 12;15(1):25207. doi: 10.1038/s41598-025-10198-5.
Sleep disturbances impair neurocognitive function, but their impact on early psychomotor recovery after day surgery remains unclear. This study aimed to investigate the impact of preoperative sleep disturbance on postoperative psychomotor recovery in patients undergoing hysteroscopic day surgery under general anesthesia, with a focus on psychomotor function and emergence from anesthesia. A prospective cohort study was conducted, including 110 patients scheduled for elective hysteroscopic day surgery. Participants were divided into two groups based on their Pittsburgh Sleep Quality Index (PSQI) scores: the Non-Sleep Disturbance (NSD) group (PSQI ≤ 5) and the Sleep Disturbance (SD) group (PSQI > 5). Psychomotor recovery was assessed using the Digit Symbol Substitution Test (DSST) and Trail Making Tests (TMT-A and TMT-B) at 30, 60, and 90 min post-extubation. Secondary outcomes included anesthesia-related time parameters, postoperative adverse events, and sleep quality on postoperative days 1 and 3, evaluated using the Athens Insomnia Scale (AIS). At 30 min post-extubation, the NSD group demonstrated significantly better psychomotor performance than the SD group (DSST: P = 0.0312; TMT-A: P = 0.0008; TMT-B: P = 0.0146). However, percentage change analysis for TMT-A revealed no significant differences between groups at any time point. No significant differences were observed between groups at 60-90 min for DSST or TMT-B. The SD group had a shorter anesthesia induction time (P < 0.0001), but no differences were found in eye-opening or extubation times. Both groups achieved similar Aldrete scores in the PACU (P = 0.7699). Postoperative sleep quality (AIS scores) and adverse events, including pain, nausea, and dizziness, were comparable between the groups. Patients with preoperative sleep disturbances undergoing general anesthesia exhibit delayed psychomotor recovery in the early postoperative phase, particularly within 30 min post-extubation. Continuous monitoring during this critical period is essential to ensure patient safety and optimize recovery outcomes in day surgery settings.
睡眠障碍会损害神经认知功能，但其对日间手术术后早期精神运动恢复的影响尚不清楚。本研究旨在调查全身麻醉下行宫腔镜日间手术患者术前睡眠障碍对术后精神运动恢复的影响，重点关注精神运动功能和麻醉苏醒情况。进行了一项前瞻性队列研究，纳入110例行择期宫腔镜日间手术的患者。参与者根据匹兹堡睡眠质量指数（PSQI）得分分为两组：非睡眠障碍（NSD）组（PSQI≤5）和睡眠障碍（SD）组（PSQI>5）。拔管后30、60和90分钟，使用数字符号替换测验（DSST）和连线测验（TMT-A和TMT-B）评估精神运动恢复情况。次要结局包括麻醉相关时间参数、术后不良事件以及术后第1天和第3天的睡眠质量，使用雅典失眠量表（AIS）进行评估。拔管后30分钟，NSD组的精神运动表现明显优于SD组（DSST：P=0.0312；TMT-A：P=0.0008；TMT-B：P=0.0146）。然而，TMT-A的百分比变化分析显示，各时间点两组之间无显著差异。DSST或TMT-B在60-90分钟时两组之间未观察到显著差异。SD组的麻醉诱导时间较短（P<0.0001），但睁眼或拔管时间无差异。两组在麻醉后恢复室（PACU）的Aldrete评分相似（P=0.7699）。两组术后睡眠质量（AIS评分）和不良事件，包括疼痛、恶心和头晕，相当。全身麻醉下术前有睡眠障碍的患者在术后早期精神运动恢复延迟，尤其是在拔管后30分钟内。在此关键时期进行持续监测对于确保日间手术环境中的患者安全和优化恢复结局至关重要。
