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

Guangyou Duan,* Kai Wang,* Taotao Peng, Zhuoxi Wu, Hong Li Department of Anesthesiology, Second Affiliated Hospital, Army Medical University, Chongqing 400037, People’s Republic of China*These authors contributed equally to this workCorrespondence: Hong LiDepartment of Anesthesiology, Seco...

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Autores principales: Duan G, Wang K, Peng T, Wu Z, Li H
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Publicado: Dove Medical Press 2020
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spelling oai:doaj.org-article:e050427158574cf6b9af5b01550391612021-12-02T12:13:16ZThe 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 Study1179-1608https://doaj.org/article/e050427158574cf6b9af5b01550391612020-03-01T00:00:00Zhttps://www.dovepress.com/the-effects-of-intraoperative-dexmedetomidine-use-and-its-different-do-peer-reviewed-article-NSShttps://doaj.org/toc/1179-1608Guangyou Duan,* Kai Wang,* Taotao Peng, Zhuoxi Wu, Hong Li Department of Anesthesiology, Second Affiliated Hospital, Army Medical University, Chongqing 400037, People’s Republic of China*These authors contributed equally to this workCorrespondence: Hong LiDepartment of Anesthesiology, Second Affiliated Hospital, Army Medical University, Chongqing 400037, People’s Republic of ChinaTel +8613608380123Fax +862368774997Email lh78553@163.comObjective: 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.Keywords: dexmedetomidine, intraoperative use, postoperative sleep disturbanceDuan GWang KPeng TWu ZLi HDove Medical Pressarticledexmedetomidineintraoperative usepostoperative sleep disturbancePsychiatryRC435-571Neurophysiology and neuropsychologyQP351-495ENNature and Science of Sleep, Vol Volume 12, Pp 209-219 (2020)
institution DOAJ
collection DOAJ
language EN
topic dexmedetomidine
intraoperative use
postoperative sleep disturbance
Psychiatry
RC435-571
Neurophysiology and neuropsychology
QP351-495
spellingShingle dexmedetomidine
intraoperative use
postoperative sleep disturbance
Psychiatry
RC435-571
Neurophysiology and neuropsychology
QP351-495
Duan G
Wang K
Peng T
Wu Z
Li H
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
description Guangyou Duan,* Kai Wang,* Taotao Peng, Zhuoxi Wu, Hong Li Department of Anesthesiology, Second Affiliated Hospital, Army Medical University, Chongqing 400037, People’s Republic of China*These authors contributed equally to this workCorrespondence: Hong LiDepartment of Anesthesiology, Second Affiliated Hospital, Army Medical University, Chongqing 400037, People’s Republic of ChinaTel +8613608380123Fax +862368774997Email lh78553@163.comObjective: 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.Keywords: dexmedetomidine, intraoperative use, postoperative sleep disturbance
format article
author Duan G
Wang K
Peng T
Wu Z
Li H
author_facet Duan G
Wang K
Peng T
Wu Z
Li H
author_sort Duan G
title 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
title_short 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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_sort 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
publisher Dove Medical Press
publishDate 2020
url https://doaj.org/article/e050427158574cf6b9af5b0155039161
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