Effects Of Boluses Of Dexamethasone On Early Postoperative Sleep Function In Patients Undergoing Laparoscopic Uterine Procedure Under General Anesthesia

Objective To investigate the effects of boluses of dexamethasone on early postoperative sleep function in patients undergoing laparoscopic uterine procedure under general anesthesia.Methods Ninety patients,scheduled for Laparoscopic Myomectomy(LM)or Laparoscopic Total Hysterectomy(LTH)undergoing total intravenous anesthesia,were randomly divided into three groups(n = 30): control group(group C),observation group 1(group DEX1)and observation group 2(group DEX2).All patients in three groups were administered the same anesthesia strategy.Patients in in three groups were given the routine anesthesia induction,dexamethasone 5mg and dexamethasone 5mg were extra intravenous injected into patients in DEX1 group and in DEX2 group respectively during the anesthesia induction.Pittsburgh Sleep Quality Index(PSQI)was used to appraise the sleep function at 1 d before operation and 1,2 d after operation.Postoperative sleep disturbances(POSD)was diagnosed with the total score of PSQI ≥ 7,and the incidences of early postoperative sleep disorders were compared among the three groups.The visual analog scale(VAS)was used to evaluate the intensity of pain at 1 d before the operation and at 2 h,4 h,8 h,12 h,24 h and 48 h after the operation during the rest and activity.The morbidity of postoperative nausea and vomiting(PONV)were compared among the three groups.The levels of blood glucose were compared at 1 d before surgery,after anesthesia induction,2 hours and 24 hours after surgery.Blood samples were collected at the morning of 1 d before operation,and 1 d,2 d after operation for detection of the the levels of perioperative cortisol,melatonin,and inflammatory factors among the three groups by Enzyme-linked immunosorbent assay(ELISA).Results The incidences of POSD for patients in group C,group DEX1 and group DEX2 were 86.7%,83.3%,and 83.3% at 1 d after operation,respectively,and there have no significant differences among the three groups(P > 0.05).The incidences of POSD for patients in group C,group DEX1 and group DEX2 were 56.7%,43.3%,and 46.7% at 2 d after operation,respectively.They have no significant differences,too(P > 0.05).Compared with group C,the scores of daytime disfunction were significantly decreased at 1 d after operation in group DEX1 and group DEX2(P < 0.05).,and there were significantly decrease at 2 d after operation in group DEX2(P < 0.05).Compared with group C,VAS scores of resting state were significantly decreased in group DEX1 and group DEX2 within 24 h after operation(P < 0.05).Compared with group C,VAS scores of activity state were significantly decreased in group DEX2 at 12 h after operation(P < 0.05).The incidences of nausea and vomiting in group DEX1 and group DEX2 were significantly decreased within 24 h after operation(P < 0.05).Perioperative blood glucose,cortisol,melatonin and inflammatory factors levers among the three groups have no significant differences(P > 0.05).Conclusion Intravenous injection of dexamethasone(5 mg or 10 mg)during anesthesia induction can’t affect the early postoperative sleep function of patients undergoing laparoscopic uterine procedure under general anesthesia.It is beneficial to relieve postoperative pain within 24 h after surgery and can reduce the incidence of postoperative nausea and vomiting at 24 h after surgery.