右美托咪啶对腹腔镜胆囊切除术后患者早期睡眠的影响
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摘要
目的观察右美托咪啶对腹腔镜胆囊切除术后患者早期睡眠的影响。方法将择期行腹腔镜胆囊切除手术的患者60例,采用抽签法分为右美托咪啶组和对照组,每组30例。收集患者术前一般临床资料、匹兹堡睡眠质量指数(PSQI)评分;术中右美托咪啶组给予静脉泵注右美托咪啶,负荷剂量1μg/kg(4μg/ml),10min内泵完,并按0.3μg/(kg·h)持续泵注至术毕前30min;对照组以同样方式输注等量0.9%氯化钠溶液。记录患者术后第2天18:00时阿森斯睡眠量表(AIS)评分;记录患者术后不良反应及睡眠满意度评分。结果两组患者一般资料、术前PSQI评分及手术时间差异均无统计学意义(均P>0.05)。两组患者术后疼痛、恶心、呕吐和心动过缓的发生率差异均无统计学意义(均P>0.05),与对照组比较,右美托咪啶组患者AIS评分显著降低,AIS量表指标中易醒、总睡眠时间、总体睡眠质量、对白天情绪影响和白天思睡情况有影响者比例显著降低;右美托咪啶组患者可疑睡眠障碍和睡眠障碍的发生率显著低于对照组,而睡眠满意度评分明显增高,差异均有统计学意义(均P<0.05)。结论右美托咪啶可以有效改善腹腔镜胆囊切除术后患者早期睡眠质量,提高患者术后睡眠满意度,值得临床推广应用。
Objective To investigate the effect of dexmedetomidine on early postoperative sleep quality in patients undergoing laparoscopic cholecystectomy. Methods Sixty ASA I or II patients scheduled for elective laparoscopic cholecystectomy were randomly allocated into Dexmedetomidine group(n=30) and control group(n=30). Clinical data of patients and Pittsburgh Sleep Quality Index(P S QI) scores were recorded before the surgery; and Athens Insomnia Scale(AIS) scores were assessed at 18:00 on postoperative d2; the side effects and sleep satisfaction of patients were also documented. Results There were no significant difference in the general data of patients, preoperative PSQI score and duration of surgery between two groups(P >0.05), and the incidence of postoperative pain, nausea, vomiting and bradycardia were also not significantly different between the two groups(P >0.05). Compared with the control group, the AIS scores were decreased in the dexmedetomidine group, and the influence rate of AIS indicators were decreased, among which the awakening, the total sleep time, the overall sleep quality, the impact on the daytime mood and the daytime sleepiness were significantly lower, and the incidence of suspicious sleep disorders and sleep disorders was significantly lower(P<0.05);and the patient's sleep satisfaction score was significantly higher(P<0.05) in dexmedetomidine group. Conclusion Dexmedetomidine can effectively improve early sleep quality and postoperative sleep satisfaction in patients undergoing laparoscopic cholecystectomy, which is worthy of clinical application.
Objective To investigate the effect of dexmedetomidine on early postoperative sleep quality in patients undergoing laparoscopic cholecystectomy. Methods Sixty ASA I or II patients scheduled for elective laparoscopic cholecystectomy were randomly allocated into Dexmedetomidine group(n=30) and control group(n=30). Clinical data of patients and Pittsburgh Sleep Quality Index(P S QI) scores were recorded before the surgery; and Athens Insomnia Scale(AIS) scores were assessed at 18:00 on postoperative d2; the side effects and sleep satisfaction of patients were also documented. Results There were no significant difference in the general data of patients, preoperative PSQI score and duration of surgery between two groups(P >0.05), and the incidence of postoperative pain, nausea, vomiting and bradycardia were also not significantly different between the two groups(P >0.05). Compared with the control group, the AIS scores were decreased in the dexmedetomidine group, and the influence rate of AIS indicators were decreased, among which the awakening, the total sleep time, the overall sleep quality, the impact on the daytime mood and the daytime sleepiness were significantly lower, and the incidence of suspicious sleep disorders and sleep disorders was significantly lower(P<0.05);and the patient's sleep satisfaction score was significantly higher(P<0.05) in dexmedetomidine group. Conclusion Dexmedetomidine can effectively improve early sleep quality and postoperative sleep satisfaction in patients undergoing laparoscopic cholecystectomy, which is worthy of clinical application.
引文
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[9]王冰.盐酸右美托咪啶辅助镇静对老年患者行椎管内麻醉术后睡眠功能的影响[J].世界临床医学,2017,11(13):16.
[10]房君,王瑞春,郑晋伟.右美托咪啶对老年患者全髋关节置换术后早期睡眠质量的影响[J].中国现代医生,2018,56(7):93-96.
[2]Rawtaer I,Mahendran R,Chan HY,et al.A nonpharmacological approach to improve sleep quality in older adults[J].Asia Pac Psychiatry,2018,10(2):e12301.DOI:10.1111/appy.12301.
[3]Saroyan JM,Evans EA,Segoshi A,et al.Interviewing and urine drug toxicology screening in a pediatric pain management center:an analysis of analgesic nonadherence and aberrant behaviors in adolescents and young adults[J].Clin J Pain,2016,32(1):1-6.DOI:10.1097/AJP.0000000000000231.
[4]Chou WH,Lin FS,Lin CP,et al.Mirtazapine,in orodispersible form,for patients with preoperative psychological distress:A pilot study[J].Acta Anaesthesiol Taiwan,2016,54(1):16-23.DOI:10.1016/j.aat.2015.12.002.
[5]汪华玲.腹腔镜胆囊切除术围术期全面护理干预的实施及效果评价[J].国际护理学杂志,2017,36(1):140-142.DOI:10.3760/cma.j.issn.1673-4351.2017.01.047.
[6]Wu XH,Cui F,Zhang C,et al.Low-dose Dexmedetomidine Improves Sleep Quality Pattern in Elderly Patients after Noncardiac Surgery in the Intensive Care Unit:A pilot Randomized Controlled Trial[J].Anesthesiology,2016,125(5):979-991.DOI:10.1097/ALN.00000000 00001325.
[7]Wang PK,Cao J,Wang H,et al.Short-Term Sleep DisturbanceInduced Stress Does not Affect Basal Pain Perception,but Does Delay Postsurgical Pain Recovery[J].J Pain,2015,16(11):1186-1199.DOI:10.1016/j.jpain.2015.07.006.
[8]盛静,方芳,贵文君,等.老年人睡眠量表在临床应用中的心理测量标准化问题[J].中国老年学杂志,2018,38(1):220-224.DOI:10.3969/j.issn.1005-9202.2018.01.093.
[9]王冰.盐酸右美托咪啶辅助镇静对老年患者行椎管内麻醉术后睡眠功能的影响[J].世界临床医学,2017,11(13):16.
[10]房君,王瑞春,郑晋伟.右美托咪啶对老年患者全髋关节置换术后早期睡眠质量的影响[J].中国现代医生,2018,56(7):93-96.