Effect Of Dexmedetomidine Hydrochloride On Postoperative Sleep Quality In Surgical Patients

Objective:This study intends to evaluate the effect of dexmedetomidine on postoperative sleep quality in surgical patients under different adminis-tration methods and doses.Methods:A total of 64 patients(aged 18～75 years,male or female)with ASA I or II and BMI of 18～30 kg/m~2 scheduled for elective thoracoscopic pulmonary surgery from June 2019 to December 2019 were selected.The patients were randomly divided into 4 groups(n=16 per group):Patients in group D1 were programmed to receive a continuous dosage of dexmedet-omidine 0.2 ug/(kg·h)for 1h at the beginning of surgery,patients in group D2were programmed to receive a continuous dosage of dexmedetomidine 0.7ug/(kg·h)for 1h at the beginning of surgery,patients in group D3 were added with 200 ug dexmedetomidine(200ug/100ml,2ml/h)in the PCA,and the PCA was connected to the venous access and enabled after surgery,and patients in group C(control group)were not treated with dexmedetomidine during perioperative period.Intraoperative and postoperative PSI values were monitored and electroencephalography was recorded by using the Sed Line brain function monitor.Polyman software was used to analyze the EEG data of patients recorded by Sed Line brain function monitor from leaving the operating room to 7AM on the first day after surgery,and the total sleep time on the operation day,night sleep time,NREM stage III and IV duration,and the proportion of patients with EEG background of fast waves in the four groups was calculated.MMSE scores were performed in the ward 1 day before surgery and on the third postoperative day to determine the cognitive function of the patients,and the patients were followed up for 3 months after surgery for personality and sleep quality changes.Results:Comparison of sleep related data and EEG background,compared with group C,group D2 had prolonged TST and NST,an increased proportion of patients with background fast waves(P<0.05),and patients in groups D1 and D3 had prolonged NST,an increased proportion of patients with background fast waves(P<0.05).Compared with group D1、D3,TST and NST were prolonged and the proportion of patients with background fast waves was increased in group D2(P<0.05),while there was no significant difference in the above parameters in group D1 and D3(P>0.05);there was no significant difference in the duration of N3 and N4 among the four groups(P>0.05).The postoperative follow-up results showed that there was no significant difference in the incidence of cognitive function change 3 days after operation,the incidence of personality change and subjective sleep quality change 3 months after operation among the four groups(P>0.05).Conclusions:Dexmedetomidine can improve postoperative sleep quality,but has no significant effect on postoperative short-term cognitive function and long-term sleep quality.