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
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
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DOI：
10.2147/nss.s239706
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发表时间：
2020-01-01
影响因子：
3.4
通讯作者：
Li, Hong
中科院分区：
文献类型：
--
作者：
Duan, Guangyou;Wang, Kai;Li, Hong
目的：本研究旨在探讨术中右美托咪定对不同手术患者术后睡眠障碍的影响，并比较不同剂量右美托咪定对术后睡眠障碍的影响。根据手术期间右美托咪定的使用情况，将患者分为DEX（右美托咪定）或非DEX（非右美托咪定）组。报告夜间无法入睡或手术当天大部分时间反复醒来且NRS>6的患者被定义为严重睡眠障碍病例。基于所有术前基线数据进行倾向评分匹配分析，沿着逻辑回归分析，包括不同手术类型和右美托咪定使用剂量。（OR，0.49 [95%CI：0.43-0.56]）和匹配队列（0.49 [95%CI：0.42-0.58]），DEX组严重睡眠障碍的发生率显著低于非DEX组。在亚组分析中，妇科和泌尿外科手术人群中，DEX组的OR为0.21（95%CI，0.13-0.33; P
Objective: 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