Objective: To investigate the effects of dexmedetomidine used to supplement analgesia on sleep quality in elderly patients after abdominal surgery.
Methods: Ninety-eight elderly patients, 56 males and 42 females, aged 65-80 years, BMI 18.5-25.0 kg/m2, ASA physical status Ⅱ or Ⅲ, who underwent elective abdominal surgery under general anesthesia were selected and divided into two groups using the random number table method: dexmedetomidine group (group D) and control group (group C), 49 patients in each group. The two groups were used the same drugs for induction and maintenance of anesthesia, with different analgesic formulas after surgery. Analgesia formula in group C was sufentanil 2 μg/kg, tropisetron 4 mg, and normal saline to 100 ml, and in group D was sufentanil 2 μg/kg, dexmedetomidine 5 μg/kg, tropisetron 4 mg, and normal saline to 100 ml. In the form of questionnaire survey, consensus sleep diary (CSD) was used to record the patient's sleep latency, number of awakenings and duration of waking after sleep 1 day before surgery and 1 day, 3, and 7 days after surgery, and then the actual sleep time and sleep efficiency were calculated. The patient's venous blood was collected at 5:00 to 7:00 in the morning to detect serum melatonin, interleukin-6 (IL-6), interleukin-1β (IL-1β) and tumor necrosis factor (TNF-α) concentration. Extubation time, the incidence of cough, agitation, respiratory depression, postoperative bradycardia, nausea and vomiting, lethargy, urinary retention, and other adverse reactions were recorded.
Results: Compared with group C, the sleep latency was significantly reduced, the actual sleep time and the sleep efficiency were significantly increased 1 day, 3, and 7 days after surgery (P < 0.05). Compared with group C, the concentration of postoperative melatonin in group D were significantly increased 1 day, 3, and 7 days after surgery (P < 0.05), the concentration of IL-6, IL-1β and TNF-α in group D were significantly reduced 1 and 3 days after surgery (P < 0.05). There was no significant difference in the incidence of adverse reactions between the two groups.
Conclusion: Patient-controlled intravenous analgesia with dexmedetomidine assisted in elderly patients after abdominal surgery can improve sleep efficiency, increase sleep time and postoperative sleep quality, which may be related to the changes of melatonin and inflammatory factors after surgery. |
