心脏手术患者术前长期睡眠障碍与术后痛觉过敏的关系

Relationship between preoperative long-term sleep disorder and postoperative hyperalgesia in patients undergoing cardiac surgery

目的:评价心脏手术患者术前长期睡眠障碍与术后痛觉过敏的关系。方法:全身麻醉下行体外循环心脏瓣膜手术患者181例,年龄≥18岁,性别不限。术前1 d采用匹兹堡睡眠质量指数(PSQI)问卷评估其最近1个月的睡眠质量,PSQI>5分表明存在长期睡眠障碍。术后进行舒芬太尼镇痛。术后根据数字疼痛量表(NRS)评分将患者分为2组:无痛觉过敏组(NHA组,NRS评分<4分)和痛觉过敏组(HA组,NRS评分≥4分)。采用logistic回归分析筛选术后痛觉过敏的危险因素。结果:logistic回归分析显示,吸烟史和术前长期睡眠障碍是术后痛觉过敏的独立危险因素(P<0.05)。结论:术前长期睡眠障碍可能导致心脏手术患者术后痛觉过敏。

Objective To evaluate the relationship between preoperative long-term sleep disorder and postoperative hyperalgesia in the patients undergoing cardiac surgery.Methods One hundred and eighty-one adult patients of both sexes,aged 18 yr,undergoing elective cardiac valve surgery under cardiopulmonary bypass with general anesthesia,were enrolled in this study.On 1st day before surgery,the Pittsburgh Sleep Quality Index questionnaire was used to assess the patient′s sleep quality in the last month.When Pittsburgh Sleep Quality Index score was more than 5,the patient was considered to have long-term sleep disorder.Postoperative analgesia was performed with sufentanil.Patients were divided into 2 groups according to the numeric rating scale(NRS)score:non-hyperalgesia group(NHA group,NRS score<4)and hyperalgesia group(HA group,NRS score≥4).A multivariate logistic regression was used to identify the risk factors associated with postoperative hyperalgesia.Results The results of logistic regression analysis found that smoking and preoperative long-term sleep disorder were independent risk factors for postoperative hyperalgesia.Conclusion Preoperative long-term sleep disorder may induce hyperalgesia after cardiac surgery in patients.