通讯作者: 王晓鹏, wangxiaopeng@sxbqeh.com.cn

DOI：10.12201/bmr.202608.00050

Effect of dexmedetomidine on sleep quality in elderly patients with short-term insomnia after general anesthesia

• 摘要：【摘要】 目的 探讨右美托咪定（Dexmedetomidine，Dex）对短期失眠老年胃肠道肿瘤患者全身麻醉术后睡眠质量的影响。 方法 择期腹腔镜胃肠道肿瘤根治术的短期失眠老年患者84例，随机分为两组：Dex组和生理盐水（normal saline，NS）组，每组n=42。Dex组麻醉诱导、术中维持以及术后患者自控静脉镇痛（Patient-controlled intravenous analgesia，PCIA）联合应用Dex，NS组给予等体积生理盐水。术前及术后1~3晚采用理查兹-坎贝尔睡眠问卷（Richards-Campbell Sleep Questionnaire，RCSQ）评估睡眠，智能手环采集客观睡眠结构数据；术前、术后1d、3d检测血清白介素-6（Interleukin-6，IL-6）；记录术后Ramsay镇静评分、视觉模拟评分（Visual analogue scale，VAS）、恢复质量-15 量表（Quality of Recovery-15，QoR-15）、3分钟谵妄诊断量表（3-minute Diagnostic Interview for CAM，3D-CAM）结果；统计心动过缓、低血压等不良事件。 结果 Dex组患者术后3晚夜间RCSQ评分明显高于NS组，且优于本组术前基线（P＜0.05）。客观睡眠数据显示，Dex 组术后睡眠总时长、浅睡眠及快速眼动睡眠（Rapid eye movement，REM）占比升高，夜间清醒次数减少（P＜0.05）。Dex 组术后 IL-6 水平低于 NS 组（P＜0.05）；术后 3、7d Dex 组 QoR-15 评分更高（P＜0.05）；两组各时点 VAS、Ramsay 评分无统计学差异；不良事件、术后谵妄发生率组间无差异。 结论 右美托咪定能有效提升短期失眠老年胃肠道肿瘤患者全麻术后睡眠质量，促进术后恢复。

  关键词： 右美托咪定; 睡眠质量; 失眠; 老年; 胃肠道肿瘤; 患者自控静脉镇痛

   

  Abstract: 【Abstract】Objective To investigate the effect of dexmedetomidine (Dex) on sleep quality in elderly patients with gastrointestinal tumors who suffer from short-term insomnia following general anesthesia. Methods Eighty-four elderly patients with short-term insomnia undergoing elective laparoscopic curative surgery for gastrointestinal tumors were randomly divided into two groups: a Dex group and a normal saline (NS) group, each with n=42. The Dex group received Dex during anesthesia induction, intraoperative maintenance, and postoperative patient-controlled intravenous analgesia (PCIA), while the NS group received an equal volume of normal saline. Sleep quality was assessed preoperatively and during the first three postoperative nights using the Richards-Campbell Sleep Questionnaire (RCSQ), and objective sleep architecture data were collected via smart wristbands. Serum interleukin-6 (IL-6) levels were measured preoperatively and on postoperative days 1 and 3. Postoperative Ramsay sedation scores, visual analog scale (VAS) pain scores, Quality of Recovery-15 (QoR-15) scores, and results of the 3-minute Diagnostic Interview for CAM (3D-CAM) were recorded. Incidences of bradycardia, hypotension, and other adverse events were documented. Results The RCSQ scores during nighttime hours over the three postoperative nights were significantly higher in the Dex group compared to the NS group and also superior to their own preoperative baseline values (P < 0.05). Objective sleep data showed that total sleep duration, light sleep, and rapid eye movement (REM) sleep proportions increased in the Dex group, while the number of nocturnal awakenings decreased (P < 0.05). Postoperative IL-6 levels were lower in the Dex group than in the NS group (P < 0.05). QoR-15 scores were higher in the Dex group on postoperative days 3 and 7 (P < 0.05). No significant differences were observed between the two groups regarding VAS or Ramsay scores at any time point. There were no differences in adverse events or incidence of postoperative delirium between the groups. Conclusion Dex effectively improves sleep quality and promotes recovery in elderly patients with gastrointestinal tumors experiencing short-term insomnia after general anesthesia.

  Key words: Dexmedetomidine; Sleep Quality; Insomnia; Elderly; Gastrointestinal tumor; Patient-controlled intravenous analgesia

  提交时间：2026-08-28

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• 序号	提交日期	编号	操作
  1	2026-06-08	10.12201/bmr.202608.00050V1	下载

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