Original ContributionEffects of dexmedetomidine administered for postoperative analgesia on sleep quality in patients undergoing abdominal hysterectomy☆,☆☆,★
Introduction
Studies showed that after major surgery, most patients experience significant disturbance in their sleep architecture, which is characterized by markedly reduced rapid eye movement (REM) sleep and slow wave sleep [1], [2], [3]. Postoperative sleep disturbance may contribute to cardiovascular, neurological, immunological, and metabolic complications, leading to increased morbidity [4], [5], [6], [7], [8]. Thus, improving the postoperative sleep quality probably has a positive effect on the recovery of surgical patients.
Dexmedetomidine, a selective α2-adrenergic receptor agonist, which is characterized by sedative, sympatholytic, and analgesic effects, has been effectively used for postoperative analgesia in patients undergoing cesarean delivery and hysterectomy [9], [10]; however, whether or not it also has a positive effect on postoperative sleep quality in these patients is to be investigated. Alexopoulou et al [11] noted that in critically ill patients, dexmedetomidine infusion during the night resulted in light sedation, thereby improving sleep quality by increasing sleep efficiency and stage 2; however, Oto et al [12] concluded that nighttime infusion of dexmedetomidine induced severely disturbed sleep architecture in mechanically ventilated patients because there was no evidence of slow wave sleep and REM sleep.
This randomized, placebo-controlled study was designed to investigate the effects of dexmedetomidine used as an adjuvant analgesic through patient-controlled analgesia (PCA) on postoperative sleep quality in patients undergoing abdominal hysterectomy.
Section snippets
Materials and methods
This study was performed between January 2015 and December 2015, and the study protocol was approved by the Ethics Committee of University Hospital of Qingdao (No.2014MZ04) on December 25, 2014. Informed written consent was obtained from all patients before study enrollment.
Results
Of all the 60 patients enrolled, 1 patient was excluded because of failed PSG measurements. The 2 groups were similar in terms of patient characteristics, intraoperative data, and recovery time at PACU (Table 1).
Compared with group C, patients in group D had a lower VAS (1.5 [0.3, 2.3], 1.3 [0.4, 2.2], and 1.0 [0.3, 2.2] vs 3.0 [2.1, 5.1], 3.0 [1.7, 4.5], and 2.5 [1.2, 3.8]) and a lower cumulative sufentanil consumption (9.0 ± 0.8, 35.0 ± 5.6, and 68.0 ± 6.5 vs 12.0 ± 1.0, 48.5 ± 5.8, and 87.5 ± 7.5; μg)
Discussion
This study aimed to investigate whether combined infusion of dexmedetomidine and sufentanil for postoperative analgesia could improve sleep quality in patients undergoing abdominal hysterectomy. The results showed that patients with abdominal hysterectomy suffer from obvious sleep disturbance characterized with a lower sleep efficiency and quality and a higher arousal index by decreasing REM and stage 3 sleep and increasing stage 1 sleep. Although there was no improvement in postoperative REM
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2023, Sleep MedicineCitation Excerpt :In a small randomized trial, 60 healthy women (30–55 years) following abdominal hysterectomy received patient-controlled analgesia with either sufentanil alone or a combination of sufentanil and dexmedetomidine (background infusion rate 0.05 μg kg−1 h−1) [24]. The results confirmed that patients given dexmedetomidine had improved sleep quality, as manifested by increased sleep efficiency and N2 sleep and decreased arousal index and N1 sleep; however, these patients had increased sedation level [24]. The effect of dexmedetomidine supplemented analgesia on sedation was also reported in a recent meta-analysis [25].
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2022, European Journal of Pharmaceutical SciencesCitation Excerpt :Notably, the fentanyl equivalent amount was relatively low in our study, with a median dose of around 185 µg. DEX administration with diverse protocols (e.g. only postoperative 0.1 μg·kg−1·h−1 infusion for 15 h, or 0.05 μg·kg−1 loading followed by 0.05 μg·kg−1·h−1 infusion through patient-controlled analgesia regimen) (Chen et al., 2017; Wu et al., 2016) have been proven to assist in postoperative sleep quality and disturbance, as assessed using different questionnaires (e.g. Numeric Rating Scales for sleep quality, or St. Mary Hospital Sleep Questionnaire) (Duan et al., 2020; Mao et al., 2020). When compared to a high DEX dose (> 0.2 μg·kg−1·h−1), a low one (0.1–0.2 μg·kg−1·h−1) showed more efficiency for ameliorating severe sleep disturbance (Cai et al., 2020).