通讯作者: 李军, lijun0068@163.com

DOI：10.12201/bmr.202505.00009

Effect of dexmedetomidine nasal spray on perioperative sleep quality and anxiety stress in patients undergoing hysterectomy

• 摘要：目的 观察右美托咪定鼻喷雾剂（dexmedetomidine nasal spray，DNS）对子宫切除术患者围手术期睡眠质量、焦虑及应激的影响。方法 选择2024年05~12月于温州医科大学附属黄岩医院全麻复合局麻下行腹腔镜子宫切除术患者75例，ASA分级Ⅰ~II级，按随机数字表法分为对照组（于术前1晚及术后当晚20:30由麻醉医师鼻喷同容量生理盐水）和试验组（相同时点鼻喷DNS50～75 μg）。主要观察指标为阿森斯失眠量表（athens Insomnia scale，AIS）评分及腕带式体动记录仪监测患者入院第1晚（T0）、术前1晚（T1）、术后当晚（T2）及术后第1晚（T3）睡眠质量。次要观察指标包括患者入院第1天、入手术室前、术后第1天、第2天医院焦虑抑郁评分（hospital anxiety and depression scale，HADS），同时点采集患者唾液样本检测皮质醇和α-淀粉酶水平；观察两组患者给药后60 min呼吸抑制、心动过缓、低血压等不良反应发生率。结果 与对照组相比，试验组患者T1、T2、T3AIS评分显著降低（P＜0.05），入睡潜伏期明显缩短、总睡眠持续时间显著延长（P＜0.05），非快速动眼睡眠时间和快速动眼睡眠时间更长（P＜0.05），T1、T2觉醒次数明显减少（P＜0.05），入手术室前、术后第1天、第2天HADS评分明显降低（P＜0.05），唾液皮质醇和α-淀粉酶水平降低（P＜0.05）。两组患者给药后60 min内不良反应发生率无明显差异（P＞0.05）。结论 DNS围手术期给药可明显改善腹腔镜子宫切除术患者睡眠质量，缓解患者焦虑情绪，降低应激水平，且安全性高。

  关键词： 子宫切除术; 右美托咪定; 鼻喷雾剂; 睡眠; 焦虑; 应激

   

  Abstract: Objective To observe the effects of dexmedetomidine nasal spray(DNS) on sleep quality, anxiety and stress of patients undergoing hysterectomy during perioperation. Methods A total of 75 patients who underwent laparoscopic hysterectomy under general anesthesia combined with local infiltration anesthesia in Affiliated Huangyan Hospital of Wenzhou Medical University from May to December in 2024 were selecetd and divided into two groups according to a random number table:control group (same volume of normal saline nasal spray at 20:30 on the night before surgery and on the night of surgery) and experimental group (50~75 μg of DNS at the same time points). The primary outcome measures included the athens insomnia scale (AIS) score and sleep quality by wrist band actigraphy on the first night of hospitalization (T0), night before surgery (T1), after surgery (T2), and first night after surgery (T3). Secondary outcome measures included hospital anxiety and depression scale(HADS) on first day hospitalization, before entering the operating room, first and second days after surgery; cortisol and α-amylase levels from saliva samples at the same time points, and the incidence of adverse reactions such as respiratory depression, bradycardia, and hypotension within 60 minutes after administration. Results Compared with control group, Patients in experimental group showed a significant decrease in AIS scores at T1, T2, and T3 (P<0.05); a shorter sleep latency and a longer total sleep duration (P<0.05); a longer NREM and REM sleep durations (P<0.05); fewer awakenings at T1 and T2 (P<0.05), a lower HADS cores, less level of salivary cortisol and α-amylase before entering the operating room, on first and second days after surgery (P<0.05). There were no significant difference in the incidence of adverse reactions within 60 minutes after administration between two groups(P>0.05). Conclusion DNS perioperatively can significantly improve sleep quality, alleviate anxiety, reduce stress levels in patients undergoing laparoscopic hysterectomy, and high safety.

  Key words: Hysterectomy；Dexmedetomidine nasal spray；Sleep；Anxiety；Stress; ; ; ; ; 

  提交时间：2025-05-13

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• 序号	提交日期	编号	操作
  1	2025-02-18	bmr.202505.00009V1	下载

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