术中持续输注右美托咪定对腹腔镜子宫肌瘤切除术患者术后睡眠质量的影响

Effect of intraoperative continuous infusion of dexmedetomidine on postoperative sleep quality in patients underwent laparoscopic hysteromyomectomy

目的:探讨术中持续输注右美托咪定对腹腔镜子宫肌瘤切除术患者术后睡眠质量的影响。方法:选取2019年6月至2021年5月在秦皇岛市工人医院行腹腔镜子宫肌瘤切除术患者150例为研究对象,随机分为对照组(n=75)与观察组(n=75)。观察组于麻醉诱导开始予以右美托咪定0.5μg/(kg·h)持续泵注,对照组则予以生理盐水0.125mL/(kg·h)泵注,直至术毕。2组术后均予以自控静脉镇痛(patient controlled intravenous analgesia,PCIA)。于术前和术后1 d、2 d行多导睡眠监测仪监测和匹兹堡睡眠指数量表(Pittsburgh Sleep Quality Index,PSQI)评分以评价2组患者睡眠质量;于术后6 h、24 h和48 h行数字镇静评分(numerical sedation scale,NSS)评价2组术后镇静效果;记录2组术后舒芬太尼用量和补救镇痛率。结果:术后1 d和2 d,观察组睡眠效率指数(sleep efficienc yindex,SEI)显著高于对照组(P<0.05),觉醒指数(arousalindex,AI)和PSQI评分显著低于对照组(P<0.05);且观察组术后当晚睡眠障碍发生率为18.67%,显著低于对照组的34.67%,差异有统计学意义(P<0.05)。相比对照组,观察组术后6 h和24 h的NSS评分显著增高(P<0.05)。相比对照组,观察组术后舒芬太尼用量减少,补救镇痛率降低,差异有统计学意义(P<0.05)。结论:术中持续输注右美托咪定能够改善腹腔镜子宫肌瘤切除术患者术后睡眠质量,对于睡眠障碍的发生有预防作用。

Objective: To investigate the effect of intraoperative continuous infusion of dexmedetomidine on postoperative sleep quality in patients undergoing laparoscopic hysteromyomectomy. Methods: A total of 150 patients undergoing laparoscopic hysteromyomectomy in Qinhuangdao Workers’ Hospital from June 2019 to May 2021 were selected and randomly divided into control group(n=75) and observation group(n=75). The observation group was continuously pumped with dexmedetomidine 0.5 μg/(kg·h) after anesthesia induction, while the control group was pumped with normal saline 0.125 mL/(kg·h) until the end of operation. Both groups received patient controlled intravenous analgesia(PCIA) after operation. The sleep quality of the 2 groups was evaluated by polysomnography and Pittsburgh Sleep Quality Index(PSQI) score before operation and 1 d and 2 d after operation. Numerical sedation scale(NSS) was used to evaluate the sedative effect at 6 h, 24 h and 48 h a?ter operation. The postoperative sufentanil dosage and remedial analgesia rate were recorded in the 2 groups. Results: At 1 d and 2 d after operation, the sleep efficiency index(SEI) in the observation group was significantly higher than that in the control group(P<0.05), and the arousal index(AI) and PSQI score were significantly lower than those in the control group(P<0.05). The incidence of sleep disorder in the observation group was 18.67%, which was significantly lower than 34.67% in the control group, and the difference was statistically significant(P<0.05). Compared with the control group, the NSS scores at 6 h and 24 h a?ter operation in the observation group were significantly increased(P<0.05). Compared with the control group, the amount of sufentanil and the rate of remedial analgesia in the observation group were decreased, and the difference was statistically significant(P<0.05). Conclusion: Continuous intraoperative infusion of dexmedetomidine can improve the postoperative sleep quality of patients undergoing laparoscopic hysteromyomectomy and prevent the occurrence of sleep disorders.