Effects Of Different Anesthesia Methods On Sleep Of Young Women After Leep Knife Surgery

Objective: To compare the effects of two different anesthesia methods on short-term and long-term sleep of young women after Leep surgery.Methods: This study was a single-center randomized controlled trial.From November 2021 to August 2022,110 young female patients underwent Leep surgery in Affiliated Hospital of Guilin Medical University.After elimination,100 cases were collected and randomly divided into general anesthesia group without intubation and spinal anesthesia group,with 50 cases in each group.In the general anesthesia group without intubation,fentanyl 1 ～ 2ug/kg and etomidate 0.1 ～ 0.4 mg/kg were provided for anesthesia induction,and propofol4 ～ 8mg/kg/h was continuously pumped by micropump for anesthesia maintenance.The spinal anesthesia group was given 2.0 ～ 2.5 ml ropivacaine injection with a concentration of 7.5 mg/ml.Main outcome measures included insomnia severity index(ISI),Euro Qol Five Dimensions(EQ-5D),sleep logs for the week from the previous day to the fifth day,and pittsburgh sleep quality index(PSQI)in the third month after discharge.Secondary outcome measures included general data such as age,body mass index(BMI),American society of anesthesiology(ASA)status rating,duration of surgery,duration of anesthesia,amount of bleeding,and incidence of postoperative nausea,vomiting,fever and delirium.Results: There was no significant difference in age,BMI,surgery time,anesthesia time and blood loss between the two groups(P > 0.05);On the day of surgery and the first day after surgery,the score of EQ-5D in spinal anesthesia group was higher than that in general anesthesia group without intubation,and the difference was statistically significant(P<0.05);On the day of surgery,the first day after surgery and the third day after surgery,the ISI score of general anesthesia group without intubation was higher than that of spinal anesthesia group,and the difference was statistically significant(P<0.001);On the day of surgery,the first day after surgery,the second day after surgery and the third day after surgery,the sleep efficiency of spinal anesthesia group was higher than that of general anesthesia group without intubation,and the difference was statistically significant(P<0.001);On the day of surgery,the first day after surgery,the second day after surgery and the third day after surgery,the score of sleep quality in spinal anesthesia group was higher than that in general anesthesia group without intubation,and the difference was statistically significant(P<0.05);On the day of surgery and the first day after surgery,the time required to fall asleep in general anesthesia group without intubation was longer than that in the spinal anesthesia group(P<0.05);On the day of surgery and the first day after surgery,the number of negative dreams in spinal anesthesia group was more than that in general anesthesia group without intubation,and the difference was statistically significant(P<0.05);On the day of surgery and the first day after surgery,the frequency of waking at night in general anesthesia group without intubation was more than that in spinal anesthesia group,and the difference was statistically significant(P<0.001).Conclusion: The effect of general anesthesia without intubation on short-term sleep quality after Leep surgery is greater than that of spinal anesthesia and there is no difference between them on long-term sleep quality after surgery.