Background This study aims to investigate the effect of preoperative sleep quality on the target plasma concentration of propofol and postoperative sleep in patients undergoing painless gastroscopy. Methods Ninety-three outpatients aged 45 to 64 years with body mass index (BMI) of 18.5–30 kg/m2 and ASA grades of I or II, who underwent painless gastroscopy, were selected. All patients were evaluated by the Athens insomnia scale (AIS) before the painless gastroscopy. The patients were divided into two groups according to the AIS score evaluated before painless gastroscopy: normal sleep group (group N, AIS score < 4 points, 47 cases) and sleep disorder group (group D, AIS score > 6 points, 46 cases). The target-controlled infusion (TCI) of propofol (Marsh model) was used for general anesthesia, the Bispectral index (BIS) was used to monitor the depth of anesthesia, and the BIS was maintained between 50 and 65 during the painless gastroscopy. The target plasma concentration (Cp) of propofol was recorded when the patient’s eyelash reflex disappeared (T1), before the painless gastroscopy (T2), at the time of advancing the gastroscope (T3) and during the painless gastroscopy (T4), and the infusion rate per body surface area of propofol was calculated. The patient’s AIS score was followed up by telephone at day 1, day 3, 1 week, and 1 month after the painless gastroscopy to assess the postoperative sleep of the patient. The occurrence of adverse reactions during the painless gastroscopy was recorded; the patient’s satisfaction and the endoscopist’s satisfaction with the anesthesia effect were compared between the two groups. Results Compared with group N, the Cp at each time point and the infusion rate per body surface area of propofol in group D was increased significantly (P < 0.05); compared with the AIS scores before the painless gastroscopy, the AIS scores of the two groups of patients were significantly increased day 1 after the painless gastroscopy (P < 0.05); there were no significant differences in the AIS scores of the two groups at day 3, 1 week, and 1 month after the painless gastroscopy (P > 0.05). There were no statistically significant differences in the occurrence of adverse reactions and the patient’s satisfaction and the endoscopist’s satisfaction with the anesthesia effect between the two groups (P > 0.05). Conclusion The preoperative sleep disturbance will increase the Cp and the infusion rate per body surface area of propofol in patients undergoing painless gastroscopy. Propofol only affects the patients’ sleep for day 1 after the painless gastroscopy. Trial registration Chinese Clinical Trial Registry (ChiCTR2100045332) on 12/04/2021.

Objective This study aimed to investigate the effects of morning and afternoon surgeries on the early postoperative sleep function in patients undergoing general anesthesia. Methods Fifty nine patients, aged 18–60 years, American society of anaesthesiologists (ASA) grade I or II, Body mass index of 18.5–28 kg/m2, undergoing laparoscopic myomectomy under total intravenous anesthesia, were included in the study. These patients were divided into two groups according to the start time of anesthesia: morning surgery group (group A, 8:00–12:00) and afternoon surgery group (group P, 14:00–18:00). The sleep conditions of the two groups of patients were evaluated by the Athens Insomnia Scale (AIS) one day before and one day after the operation. A total score of > 6 was regarded as postoperative sleep disturbance. The incidences of sleep disturbance one day after the operation in two groups were compared. The bispectral Index assessed the patient’s total sleep duration, sleep efficiency, and overall quality of sleep from 21:00 to 6:00 on the first night after surgery. Plasma concentrations of melatonin and cortisol at 6:00 am 1 day before surgery, 1 day after surgery were measured by ELISA, and rapid random blood glucose was measured. Results The total AIS score, overall quality of sleep, total sleep duration, and final awakening earlier than desired scores of the two groups of patients on the first night after surgery were significantly increased compared with preoperative scores (P < 0.01). In group P, the sleep induction and the physical and mental functioning during the day scores increased significantly after surgery compared with preoperative scores (P < 0.05). The postoperative AIS scores in group P increased significantly compared with those in group A (P < 0.01). The incidence of postoperative sleep disturbances (70.0%) in group P was significantly higher than that in group A (37.9%) (P < 0.05). Compared with group A, the total sleep duration under BIS monitoring in group P was significantly shorter, the sleep efficiency and the overall quality of sleep was significantly reduced (P < 0.01). Compared with those in group A, the level of melatonin on 1 d after surgery in group P was significantly decreased, and the level of cortisol in group P was significantly increased. There were no significant differences between the two groups in the levels of postoperative blood glucose and pain. Conclusion Both morning and afternoon surgeries have significant impacts on the sleep function in patients undergoing general anesthesia, while afternoon surgery has a more serious impact on sleep function. Trial registration ClinicalTrials, NCT04103528. Registered 24 September 2019—Retrospectively registered, http://www.ClinicalTrials.gov/ NCT04103528.

No abstract

The study aimed to evaluate the effect of forced-air warming blanket combined with conventional thermal insulation measures on inadvertent perioperative hypothermia (IPH) in elderly patients undergoing laparoscopic radical resection of colorectal cancer. A total of 70 elderly patients undergoing laparoscopic radical resection of colorectal cancer with general anesthesia were included, and divided into conventional warming treatment (CT) group or forcedair warming treatment (FT) group. In the FT group, based on the conventional warming strategy, patients received prewarming with the forced-air warming blanket (38°C) for q20 minutes before induction of anesthesia, and received this treatment continuously during operation. The core body temperature, recovery time from anesthesia, extubating time, and length of stay in the postanesthesia care unit were recorded. The incidence of IPH and postoperative shivering was observed. The incidence of IPH was significantly lower, and average minimum body temperature during the operation was significantly higher in the FT group than that in the CT group (5.7% vs. 22.8% and 36.23°C vs. 35.89°C, respectively). The intraoperative body temperature decreased less (0.32°C vs. 0.69°C), the recovery time from anesthesia was faster (12.8 minutes vs. 17.1 minutes), and the incidence of postoperative shivering was less (2.8% vs. 28.6%) in the FT group than the CT group. In elderly patients undergoing laparoscopic radical resection of colorectal cancer, use of forced-air warming blankets combined with conventional warming measures is more effective to maintain normal body temperature during the perioperative period and reduce the incidence of IPH.

Background: Postoperative sleep disturbance (POSD) in patients with colorectal cancer is a key factor affecting their rapid postoperative recovery. Studies have confirmed that perioperative use of opioids can disturb postoperative sleep, and perioperative oligoopioids or no opioid in elderly patients can promote postoperative recovery. To reduce the use of opioids, this study was to investigate the effect of perioperative intravenous lidocaine analgesia on the postoperative sleep of elderly patients undergoing laparoscopic radical resection for colorectal cancer. Methods 63 patients aged 65-80 years with body mass index (BMI) values of 20-30 kg/m2 and American society of anesthesiologists (ASA) grades of II-III, who underwent elective laparoscopic radical resection for colorectal cancer, were selected. The patients were divided into the lidocaine group (group L, n = 32) and the control group (group C, n = 31) by using a random number table. Patients in both groups received total intravenous anesthesia. In group L, a dose of 1.5 mg/kg of lidocaine was injected intravenously during induction of anesthesia, and lidocaine (1.0 mg·kg-1·h-1) was injected intravenously during surgery and for 24 hours after surgery. In Group C, the same volume of normal saline was injected, and intravenous patient-controlled analgesia (Sufentanil 1.5-1.8 μg/kg) was given after surgery. The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate the sleep function 1 d before surgery, 1 d, 2 d, and 3 d after surgery. The incidence of postoperative sleep disturbance (POSD) at 1 d, 2 d and 3 d after surgery was calculated. The pain intensity of the two groups at different time points after surgery was evaluated. The intraoperative consumption of opioids and propofol and the incidence of postoperative complications and lidocaine adverse reactions in 2 groups were recorded. Results Compared with group C, sleep quality, sleep latency, sleep duration, sleep efficiency, sleep disturbance, daytime dysfunction scores, and total PSQI score was improved significantly in group L at 1 d, 2 d, and 3 d after surgery (P <0.05). Compared with group C, the incidence of POSD in group L was lower, and the difference was statistically significant (P <0.05). There was no significant difference in postoperative pain intensity between the two groups (P > 0.05) Compared with group C, the consumption of opioids and propofol in group L decreased significantly (P <0.05). There was no statistically significant difference in the incidence of postoperative complications. No patient in group L had side effects of lidocaine. Conclusions For elderly patients undergoing laparoscopic radical resection of colorectal cancer, perioperative intravenous lidocaine infusion can improve the early postoperative sleep quality, reduce the incidence of postoperative sleep disturbance, and promote the recovery of postoperative sleep function.