Intraoperative infusion of dexmedetomidine provided smooth and haemodynamically stable emergence. It also improved quality of recovery after nasal surgery.

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Objective: The Coronavirus Disease 2019 (COVID-19) pandemic is a public health emergency of international concern and poses a challenge to people’s psychological resilience. Students are reported to have greater psychological impacts from COVID-19. This study aimed to survey international students to better understand their traumatic effects and psychological reactions from COVID-19, to develop evidence-driven strategies to reduce adverse psychological impact during the pandemic. Method: We conducted an online survey that collected information on the demographics, economic conditions, academic conditions, and health statuses of native Chinese students attending university in the U.S. Psychological impact was assessed by the Post-traumatic Stress Disorder (PTSD) Checklist Civilian Version (PCL-C) and mental health status was assessed by the Depression, Anxiety, and Stress Scale. Results: This study included 261 Chinese international students. In total, 37.5% of respondents’ PTSD PCL-C scores measured as moderate or severe. International students who were currently in China facing job-hunting or planning to continue studying abroad, severe economic pressure, and poor self-rated health status were significantly associated with greater PTSD PCL-C scores and higher levels of stress, anxiety, and depression. Conclusion: During the COVID-19 pandemic, more than one-third of the respondents rated their PTSD PCL-C score as moderate-to-severe and nearly half of them reported moderate-to-severe anxiety. Our findings identify factors such as future academic plan, economic pressure, and health status are associated with higher levels of psychological impact and worse mental health status. These should receive attention and psychological interventions should be implemented to improve the mental health of international students during the COVID-19 pandemic.

ObjectivesThe 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.MethodsSeventy-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.ResultsIntraoperative 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.ConclusionUsing dexmedetomidine during the daytime operation can better improve postoperative sleep quality and pain than nighttime operation in patients undergoing laparoscopic abdominal surgeries.

The purpose of this article is to review (1) sleep mechanism under general anesthesia, harmful effects of postoperative sleep disturbances; (2) risk factors associated with postoperative sleep disturbances; (3) measures to prevent and improve postoperative sleep disturbances. General anesthesia changes the postoperative sleep structure especially in elderly patients after major surgery and results in a high incidence rate of sleep disturbances. Sleep disturbances produce harmful effects on postoperative patients and lead to a higher risk of delirium, more cardiovascular events, and poorer recovery. Some researchers do propose non-pharmacological treatments such as attention to environmental and psychological factors, application of electroacupuncture (EA) technology and pharmacological treatments are helpful, but larger high-quality clinical trials with longer following-up are needed to further investigate the efficacy and safety.