术前连续雾化吸入右美托咪定对中老年患者结直肠癌根治术后睡眠的影响  

Effect of preoperative continuous nebulized dexmedetomidine on postoperative sleep in middle-aged and elderly patients undergoing colorectal cancer resection

作　　者：吴松涛 甘建辉[1] 何双亮[1] 施丞楠 杨建辉 王志刚[2] WU Songtao;GAN Jianhui;HE Shuang-liang;SHI Chengnan;YANG Jianhui;WANG Zhigang(Department of Anesthesiology,Tangshan People's Hospital,Tangshan 063000,China)

机构地区：[1]唐山市人民医院麻醉科,063000 [2]邯郸市中心医院麻醉科

出　　处：《临床麻醉学杂志》2025年第4期341-345,共5页Journal of Clinical Anesthesiology

基　　金：河北省自然科学基金(H2023109002)。

摘　　要：目的探讨术前连续雾化吸入右美托咪定对中老年患者结直肠癌根治术后睡眠质量的影响。方法选择择期行结直肠癌根治术的患者67例,男31例,女36例,年龄46~75岁,BMI 18.5~30.0 kg/m^(2),ASAⅠ—Ⅲ级。采用随机数字表法将患者分为两组:右美托咪定组(DEX组,n=34)和生理盐水组(NS组,n=33),每组35例。DEX组于入院当日晚间雾化吸入右美托咪定1μg/kg,每次10 min,每次间隔24 h,直到术前1 d。NS组接受等量的生理盐水雾化吸入。记录术后1 d睡眠障碍发生率,入院时、术后1 d匹兹堡睡眠质量指数量表(PSQI)评分,入院时、术后1、3、5、7 d状态特质焦虑量表(STAI-S)评分,手术时间、拔管时间,术后静息和活动时数字评价量表(NRS)疼痛评分、镇痛泵总按压次数、有效按压次数、补救镇痛情况和术后恶心呕吐(PONV)、嗜睡情况,术后住院时间。结果与NS组比较,DEX组术后1 d睡眠障碍发生率、术后1 d PSQI评分和术后1、3、5、7 d STAI-S评分、术后1 d NRS疼痛评分、镇痛泵总按压次数、有效按压次数和补救镇痛率明显降低,术后住院时间明显缩短(P<0.05)。两组手术时间、拔管时间、PONV和嗜睡发生率差异无统计学意义。结论术前持续雾化吸入右美托咪定能改善中老年患者结直肠癌根治术后早期睡眠质量,并有效降低术后睡眠障碍的发生率。Objective To investigate the impact of preoperative continuous nebulization of dexmedetomidine on postoperative sleep disturbances in patients undergoing colorectal resection.Methods Sixty-seven patients scheduled for colorectal cancer resection were selected,31 males and 36 females,aged 46 to 75 years,BMI 18.5 to 30.0 kg/m^(2),and ASA physical statusⅠ—Ⅲ.Patients were randomly divided into two groups using a random number table:the dexmedetomidine group(group DEX,n=34)and normal saline group(group NS,n=33).The patients in group DEX received a dose of 1μg/kg of dexmedetomidine via nebulization for 10 minutes each time at an interval of 24 hours on the evening of admission until the day before surgery.Patients in group NS received an equal volume of saline nebulization.The incidence of sleep disorders on postoperative day 1,the Pittsburgh sleep quality index(PSQI)score at admission and on postoperative day 1,state trait anxiety inventory(STAI-S)score at admission and on postoperative days 1,3,5,and 7 were recorded.Data on operation time,extubation time,rest and activity-related numerical rating scale(NRS)pain scores,total patient-controlled analgesia(PCA)button presses,effective PCA button presses,rescue analgesia status,postoperative nausea and vomiting(PONV),sedation occurrence and postoperative hospital stay duration were also recorded.Results Compared with group NS,group DEX had significantly lower on postoperative day 1 sleep disorder incidence,PSQI on postoperative day 1 and STAI-S scores on postoperative days 1,3,5,and 7,NRS pain scores on postoperative day 1,total PCA button presses,effective PCA button presses,and rescue analgesia rates(P<0.05),and significantly shorted the length of postoperative hospital stay(P<0.05).There was no significant difference in operation time,extubation time,PONV,and sedation occurrence between the two groups.Conclusion Preoperative continuous nebulization of dexmedetomidine treatment can significantly improve the early postoperative sleep quality in patients undergoing

关 键 词：睡眠障碍 术后焦虑 结直肠癌根治术 右美托咪定 雾化吸入 

分 类 号：R614[医药卫生—麻醉学]