Effects of dexmedetomidine administered for postoperative analgesia on sleep quality in patients undergoing abdominal hysterectomy

Chen, Zuolei; Tang, Rundong; Zhang, Rui; Yan, Junhao; Liu, Yingzhi

doi:10.1016/j.jclinane.2016.10.022

Cited by 57 publications

(45 citation statements)

References 18 publications

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“…As we know, postoperative pain was one of the most common causes affecting postoperative sleep quality, and this is reported in many previous studies. [19][20][21]30 However, we observed that intraoperative use of dexmedetomidine had no effect on improving postoperative pain, and the incidence of inadequate postoperative analgesia was similar in the DEX and Non-DEX group. Thus, we speculated that postoperative sleep quality improvement induced by intraoperative use of dexmedetomidine might be due to other causes rather than reducing postoperative pain.…”

Section: Discussionmentioning

confidence: 63%

<p>The Effects of Intraoperative Dexmedetomidine Use and Its Different Dose on Postoperative Sleep Disturbance in Patients Who Have Undergone Non-Cardiac Major Surgery: A Real-World Cohort Study</p>

Duan¹,

Wang²,

Peng³

et al. 2020

NSS

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The study aimed to investigate the effects of intraoperative dexmedetomidine on postoperative sleep disturbance for different surgical patients and compare such effects between different dose of dexmedetomidine. Methods: A total of 7418 patients undergoing nine types of non-cardiac major surgeries were retrospectively studied. Patients were separated into DEX (dexmedetomidine) or Non-DEX (Non-dexmedetomidine) groups based on the use of dexmedetomidine during surgery. The patients who reported they could not fall asleep during the night or woke up repeatedly during the most of the night at the day of the surgery and whose NRS were >6 were defined as cases with severe sleep disturbance. Propensity score matched analysis based on all preoperative baseline data was performed along with logistic regression analysis including different surgery types and dosage of dexmedetomidine use. Results: In both of the unmatched cohort (OR, 0.49 [95% CI: 0.43-0.56]) and matched cohort (0.49 [95% CI: 0.42-0.58]), the DEX group had a significantly lower incidence of severe sleep disturbance than the Non-DEX group. In the subgroup analysis, for gynecological and urological surgery population, the ORs for DEX-group reached 0.21 (95% CI, 0.13-0.33; P<0.0001) and 0.30 (95% CI,0.19-0.47; P<0.0001), respectively. In addition, low-dose dexmedetomidine (0.2-0.4 μg•kg −1 •h −1) showed the greatest effect with an odds ratio of 0.38 (95% CI: 0.31-0.44; P<0.0001), and the incidence of severe sleep disturbance in the low-dose group was significantly lower (11.5% vs. 17.7% vs. 16.5%, P<0.0001) than that in the medium-(0.4-0.6 μg•kg −1 •h −1) and high-dose (0.6-0.8 μg•kg −1 •h −1) groups. Conclusion: Intraoperative dexmedetomidine use can significantly decrease the incidence of severe sleep disturbance on the day of surgery for patients undergoing non-cardiac major surgery, and the effects were most significant in patients receiving gynecological and urological surgery. Furthermore, low-dose dexmedetomidine (0.2-0.4 μg•kg −1 •h −1) is most effective for prevention of postoperative sleep disturbance.

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Section: Discussionmentioning

confidence: 63%

<p>The Effects of Intraoperative Dexmedetomidine Use and Its Different Dose on Postoperative Sleep Disturbance in Patients Who Have Undergone Non-Cardiac Major Surgery: A Real-World Cohort Study</p>

Duan¹,

Wang²,

Peng³

et al. 2020

NSS

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“…The research presented herein revealed no substantial difference in the degree of sedation between the two groups. Dexmedetomidine has sedative qualities and acts on the subcortical system to generate sedation and enhance the quality of postoperative sleep [21][22][23] . Hence, dexmedetomidine is known to offer sedation without a respiratory disturbance, and the Ramsay sedation scores (RSS) did not indicate unnecessary sedation either.…”

Section: Discussionmentioning

confidence: 99%

Intraoperative and Postoperative Dexmedetomidine Combined With Sufentanil and Dezocine-based Patient-Controlled Intravenous Analgesia Increases Female Patients' Global Satisfaction Degree After Thoracoscopic Surgery: A Randomised Double-blind Controlled Trial

Yao

et al. 2020

Preprint

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Background：There are no studies on the use of dexmedetomidine combined with sufentanil and dezocine-based patient-controlled intravenous analgesia (PCIA) in females undergoing thoracic surgery. We postulate that introducing dexmedetomidine to a combination of dezocine-based PCA drugs and sufentanil will increase female patients' global satisfaction degree.Methods：One hundred fifty-two female patients with physical classification type I or II according to the American Society of Anesthesiologists undergoing thoracoscopic surgery were arbitrarily classified into two categories, either receiving sufentanil and dezocine-based PCIA (group C) or incorporating dexmedetomidine with sufentanil and dezocine-based PCIA (group D). The patients' global satisfaction degree, postoperative nausea and vomiting (PONV), PCA bolus, rescue analgesia requirements, drug-related adverse effects, rest and coughing visual analogue scale (VAS) ratings, and Ramsay sedation scores (RSS) were measured at 6, 12, 24, 36 and 48 h after surgery.Results：Compared with the C group, the patient satisfaction degree was significantly higher; pain scores at rest and coughing were significantly different at 6, 12, 24, 36 and 48 h postoperatively; less rescue analgesia and PCA bolus were required; and a lower incidence of PONV was found in the D group. There were non-significant trends for the sedation scores and drug-related adverse effects in both groups.Conclusions：Dexmedetomidine combined with sufentanil and dezocine increased female patients' global satisfaction degree after thoracoscopic surgery. This effect could be linked to the improvement in postoperative analgesia and reduction in postoperative nausea and vomiting; the combined treatment did not increase drug-related adverse effects in female patients.Trial registration: Chinese Clinical Trial Registry number, ChiCTR2000030429. Registered on March 1, 2020.

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“…5 group had lower PACU pain scores than those of the control group. A recent clinical meta-analysis showed that Dexmedetomidine reduced postoperative pain and opioid consumptions without respiratory suppression (26,27). It is reported that analgesic effect of Dexmedetomidine is due to its inhibitions of the conductions of Aδ-and Cnociceptive sensory fibers, and of the pain-specific sodium channel (28,29).…”

Section: Discussionmentioning

confidence: 99%

Antishivering Effect of Dexmedetomidine on Patients Undergoing Video-Assisted Thoracoscopic Wedge Resection

Lee

Park

et al. 2018

Iran Red Crescent Med J

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Background: Post-anesthetic shivering can cause post-surgical pain or discomfort, and create oxygen supply/demand imbalance. Objectives: The current study aimed at evaluating the effects of Dexmedetomidine on the incidence and intensity of shivering and core temperature after general anesthesia. Methods: The current randomized, double-blind, placebo-controlled, clinical trial was conducted at a single center (Gil Medical Center, Incheon, South Korea) from January to December 2016 with convenience sampling and simple random allocation. A total

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Effects of dexmedetomidine administered for postoperative analgesia on sleep quality in patients undergoing abdominal hysterectomy

Cited by 57 publications

References 18 publications

<p>The Effects of Intraoperative Dexmedetomidine Use and Its Different Dose on Postoperative Sleep Disturbance in Patients Who Have Undergone Non-Cardiac Major Surgery: A Real-World Cohort Study</p>

<p>The Effects of Intraoperative Dexmedetomidine Use and Its Different Dose on Postoperative Sleep Disturbance in Patients Who Have Undergone Non-Cardiac Major Surgery: A Real-World Cohort Study</p>

Intraoperative and Postoperative Dexmedetomidine Combined With Sufentanil and Dezocine-based Patient-Controlled Intravenous Analgesia Increases Female Patients' Global Satisfaction Degree After Thoracoscopic Surgery: A Randomised Double-blind Controlled Trial

Antishivering Effect of Dexmedetomidine on Patients Undergoing Video-Assisted Thoracoscopic Wedge Resection

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