The Effect Of Intraoperative Use Of Dexmedetomidine During The Daytime Operation Vs The Nighttime Operation On Postoperative Sleep Quality And Pain Under General Anesthesia

Abstract

Objectives

The aim of our study was to compare the effect of using dexmedetomidine (DEX) during the daytime operation or the nighttime operation under general anesthesia on postoperative sleep quality and pain of patients.

Methods

Seventy-five patients scheduled for elective laparoscopic abdominal surgeries under general anesthesia were randomly assigned to receive operation in the Day Group (8:00–12:00) and the Night Group (18:00–22:00). The Portable Sleep Monitor (PSM) was performed on the following 3 nights: the night before surgery (Sleep 1), the first night after surgery (Sleep 2), and the third night after surgery (Sleep 3). Postoperative pain scores using visual analogue scoring scale, subjective sleep quality using the Athens Insomnia Scale, total dose of general anesthetics and PCA pump press numbers were also recorded.

Results

Intraoperative administration of DEX for patients in the Day Group could improve sleep quality with a higher sleep efficiency and a lower AIS subjective sleep quality than patients in the Night Group at Sleep 2 (P < 0.001 and P = 0.001, respectively) and Sleep 3 (P < 0.001, respectively). There were marked lower rapid eye movement (REM) sleep and Stable sleep in the Night Group than that in the Day Group at Sleep 2 (P < 0.001 and P = 0.032, respectively) and Sleep 3 (P < 0.001, respectively). Patients in the Day Group have better pain relief and less PCA pump press numbers than patients in the Night Group.

Conclusion

Using dexmedetomidine during the daytime operation can better improve postoperative sleep quality and pain than nighttime operation in patients undergoing laparoscopic abdominal surgeries.

Keywords:

• dexmedetomidine
• sleep quality
• general anesthesia
• postoperative pain

Acknowledgments

The authors would like to thank Raymond C. Koehler, MD, Ph.D., from Departments of Anesthesiology and Critical Care Medicine, Johns Hopkins, University, Baltimore, MD, USA and Dr. Weifeng Song, MD, Ph.D., from Department of Anesthesiology and Perioperative Medicine, School of Medicine, the University of Alabama at Birmingham, Birmingham, Alabama, USA, for their discussion and advice of this study. The present study was funded by the Support Plan for Innovative Talents in Liaoning Higher Education Institution (grant no. 201834).

Abbreviations

Dexmedetomidine, DEX; Visual analog scale, VAS; The Portable Sleep Monitor, PSM; Rapid eye movement, REM; Slow wave sleep, SWS; The Athens Insomnia Scale, AIS; Heart rate, HR; Mean arterial pressure, MAP; non-invasive blood pressure, NIBP; peripheral oxygen saturation, SpO_2.

Data Sharing Statement

The individual deidentified participant data in our study could be shared with the readers. And readers can obtain the data by emailing the corresponding author ([email protected]). We did not have specific data and other study-document in our study. All the data in our study are available for ten years.

Author Contributions

All authors contributed to data analysis, drafting or revising the article, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.