Kai WANG, Guangyou DUAN, Peng ZHAO, et al. Effects of intraoperative continuous pumping of dexmedetomidine on postoperative sleep quality in patients undergoing spinal surgery[J]. Journal of Third Military Medical University, 2020, 42(10): 1002-1007.
DOI:
Kai WANG, Guangyou DUAN, Peng ZHAO, et al. Effects of intraoperative continuous pumping of dexmedetomidine on postoperative sleep quality in patients undergoing spinal surgery[J]. Journal of Third Military Medical University, 2020, 42(10): 1002-1007. DOI: 10.16016/j.1000-5404.202001016.
Effects of intraoperative continuous pumping of dexmedetomidine on postoperative sleep quality in patients undergoing spinal surgery
To investigate the effects of intraoperative continuous pumping of dexmedetomidine on postoperative sleep quality in patients undergoing spinal surgery.
Methods
2
We retrospectively analyzed the data of 3 257 patients undergoing spinal surgery between May
2018 and April
2019 collected from the medical record system of the Second Affiliated Hospital of Army Medical University. The patients were divided into dexmedetomidine (DEX) group and control group according to whether the patients received intraoperative continuous pumping of DEX. The occurrence of sleep disturbance on the first postoperative night (including sleep deprivation and repeated sleep disruption) was recorded and the incidence of sleep disturbance was compared between the 2 groups. Propensity score matching and subgroup analysis were carried out to further verify the incidences of sleep disturbance in the 2 groups.
Results
2
The incidence of sleep disturbance on the first postoperative night was 17.4% in DEX group and 29.4% in the control group (
P
<
0.000 1) in the unmatched cohort; the incidence was 18.5% the DEX group and 29.4% in the control group (
P
<
0.000 1) after propensity matching. Subgroup analysis showed that the incidence of severe sleep disturbance was significantly lower in DEX group than in the control group following cervical vertebra surgeries (20.3%
vs
28.9%
P
=0.025)
thoracic surgeries (14.6%
vs
18.2%
P
=0.580) and lumbar surgeries (16.9%
vs
30.2%
P
<
0.000 1).
Conclusion
2
Intraoperative continuous pumping of DEX helps to improve postoperative sleep quality and lower the incidence of postoperative sleep disturbance in patients undergoing spinal surgeries.
关键词
Keywords
references
GENOV P G, TIMERBAEV V K, DOLGASHEVA N S, et al . The effect of various multimodal analgesia regimens during surgical treatment of patients with spinal Stenosis on the rate of failed back surgery syndrome[J ] . Vopr Neirokhir, 2019, 83(2): 71. DOI: 10.17116/neiro20198302171.
JIANG Z M, ZHOU G Z, SONG QL, et al . Effect of intra-venous oxycodone in combination with different doses of dexmedetomdine on sleep quality and visceral pain in patients after abdominal surgery: a randomized study[J ] . Clin J Pain, 2018, 34(12): 1126-1132. DOI: 10.1097/AJP.000000 0000000645.
SRIVASTAVA S, GUPTA D, NAZ A, et al . Effects of preoperative single dose Etoricoxib on postoperative pain and sleep after lumbar diskectomy: prospective randomized dou-ble blind controlled study[J ] . Middle East J Anaesthes iol, 2012, 21(5): 725-730.
SCHEFFEL K, AMIDEI C, FITZGERALD K A. Motivational interviewing: improving confidence with self-care management in postoperative thoracolumbar spine patients[J]. J Neurosci Nurs, 2019, 51(3): 113-118. DOI: 10.1097/JNN.0000000000000431.
AURELL J, ELMQVIST D. Sleep in the surgical intensive care unit: continuous polygraphic recording of sleep in nine patients receiving postoperative care[J]. Br Med J (Clin Res Ed), 1985, 290(6474): 1029-1032. DOI: 10.1136/bmj.290.6474.1029.
KHAN N R, CLARK A J, LEE S L, et al . Surgical outcomes for minimally invasive vs open transforaminal lumbar interbody fusion: an updated systematic review and meta-analysis[J ] . Neurosurgery, 2015, 77(6): 847-874; discussion 874. DOI: 10.1227/NEU.0000000000000913..
SU X, WANG D X. Improve postoperative sleep: what can we do?[J]. Curr Opin Anaesthesiol, 2018, 31(1): 83-88. DOI: 10.1097/aco.0000000000000538.
CHOUCHOU F, KHOURY S, CHAUNY J M, et al . Postoperative sleep disruptions: a potential catalyst of acute pain?[J ] . Sleep Med Rev, 2014, 18(3): 273-282. DOI: 10.1016/j.smrv.2013.07 .002.
EVANS J L, NADLER J W, PREUD'HOMME X A, et al . Pilot prospective study of post-surgery sleep and EEG predictors of post-operative delirium[J ] . Clin Neurophysiol, 2017, 128(8): 1421-1425. DOI: 10.1016/j.clinph.2017.05.004.
KJ∅LHEDE P, LANGSTRÖM P, NILSSON P, et al . The impact of quality of sleep on recovery from fast-track abdominal hysterectomy[J ] . J Clin Sleep Med, 2012, 8(4): 395-402. DOI: 10.5664/jcsm.2032.
XIE H, KANG J, MILLS G H. Clinical review: The impact of noise on patients' sleep and the effectiveness of noise reduction strategies in intensive care units[J]. Crit Care, 2009, 13(2): 208. DOI: 10.1186/cc7154.
LE GUEN M, NICOLAS-ROBIN A, LEBARD C, et al . Earplugs and eye masks vs routine care prevent sleep impairment in post-anaesthesia care unit: a randomized study[J ] . Br J Anaesth, 2014, 112(1): 89-95. DOI: 10.1093/bja/aet304..
ROSENBERG-ADAMSEN S, KEHLET H, DODDS C, et al . Postoperative sleep disturbances: mechanisms and clinical implications[J ] . Br J Anaesth, 1996, 76(4): 552-559. DOI: 10.1093/bja/76.4.552.
CHAN I A, MASLANY J G, GORMAN K J, et al . Dexmedetomidine during total knee arthroplasty performed under spinal anesthesia decreases opioid use: a randomized-controlled trial[J ] . Can J Anesth, 2016, 63(5): 569-576. DOI: 10.1007/s12630-016-0597-y.
KIM K H. Safe sedation and hypnosis using dexmedetomidine for minimally invasive spine surgery in a prone position[J]. Korean J Pain, 2014, 27(4): 313-320. DOI: 10.3344/kjp.2014.27.4.313.
WU X H, CUI F, ZHANG C, et al . Low-dose dexmedetomidine improves sleep quality pattern in elderly patients after noncardiac surgery in the intensive care unit: a pilot randomized controlled trial[J ] . Anesthesiology, 2016, 125(5): 979-991. DOI: 10.1097/ALN.0000000000001325.
SHI C X, JIN J, PAN Q, et al . Intraoperative use of dexmedetomidine promotes postoperative sleep and recovery following radical mastectomy under general anesthesia[J ] . Oncotarget, 2017, 8(45): 79397-79403. DOI: 10.18632/oncotarget.18157.
SU X, MENG Z T, WU X H, et al . Dexmedetomidine for prevention of delirium in elderly patients after non-cardiac surger y: a randomised, double-blind, placebo-controlled trial[J ] . Lancet, 2016, 388(10054): 1893-1902. DOI: 10.1016/S0140-6736(16)30580-3.
WEERINK M A S, STRUYS M M R F, HANNIVOORT L N, et al . Clinical pharmacokinetics and pharmacodynamics of dexmedetomidine[J ] . Clin Pharmacokinet, 2017, 56(8): 893-913. DOI: 10.1007/s40262-017-0507-7.
CELIK S, OZTEKIN D, AKYOLCU N, et al . Sleep disturbance: the patient care activities applied at the night shift in the intensive care unit[J ] . J Clin Nurs, 2005, 14(1): 102-106. DOI: 10.1111/j.1365-2702.2004.01010.x.
OTO J, YAMAMOTO K, KOIKE S, et al . Sleep quality of mechanically ventilated patients sedated with dexmedetomidine[J ] . Intens Care Med, 2012, 38(12): 1982-1989. DOI: 10.1007/s00134-012-2685-y.
ANTTILA M, PENTTILÄ J, HELMINEN A, et al . Bioavailability of dexmedetomidine after extravascular doses in healthy subjects[J ] . Br J Clin Pharmacol, 2003, 56(6): 691-693. DOI:10.1046/j.1365-2125.2003.01944.x.
LEE S, KIM B H, LIM K, et al . Pharmacokinetics and pharmacodynamics of intravenous dexmedetomidine i n healthyKorean subjects[J ] . J Clin Pharm Ther, 2012, 37 (6): 698-703. DOI:10.1111/j.1365-2710.2012.01357.x.
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