Effects of dexmedetomidine administered for postoperative analgesia on sleep quality in patients undergoing abdominal hysterectomy

摘要

Study objective: To evaluate the effects of postoperative dexmedetomidine infusion on sleep quality in patients undergoing abdominal hysterectomy. Design: Randomized, double-blind study. Setting: Postoperative recovery area and ward. Patients: Sixty patients of American Society of Anesthesiologists physical status I or II scheduled for elective hysterectomy were enrolled. Interventions: Patients in group C received sufentanil infusion (a continuous dosage of 0.02 mu g kg(-1) h(-1), a bolus dose of 0.02 mu g/kg, a 10-minute lockout interval), and patients in group D received combined infusion of sufentanil with dexmedetomidine (a continuous dosage of sufentanil 0.02 mu g kg(-1) h(-1) with dexmedetomidine 0.05 mu g kg(-1) h(-1), a bolus doses of sufentanil 0.02 mu g/kg with dexmedetomidine 0.05 mu g/kg, a 10-minute lockout interval). Measurements: Polysomnography (PSG) was performed on the following 3 nights: the night before surgery (PSG1), the first night after surgery (PSG2), and the second night after surgery (PSG3). Postoperative pain scores using visual analog scoring scale, levels of sedation, and cumulative sufentanil consumptions were also recorded. Results: After surgery, patients suffered from significant sleep disturbance with a lower sleep efficiency index and subjective sleep quality and a higher arousal index at PSG2 and PSG3. Compared with group C, postoperative administration of dexmedetomidine significantly improved the sleep efficiency index and subjective sleep quality. Although the rapid eye movement and N3 stage sleep did not differ between the 2 groups, the N1 stage and arousal index were lower and the N2 stage in group D at PSG2 and PSG3 was higher. Compared with group C, patients in group D have better pain relief with a lower visual analog scoring scale and cumulative sufentanil consumptions at 6, 24, and 48 hours after surgery. Conclusions: Dexmedetomidine infusion not only offers effective analgesia but also improves postoperative sleep quality in patients undergoing hysterectomy. (C) 2016 Elsevier Inc. All rights reserved.