The effects of dexmedetomidine for patient-controlled analgesia on postoperative sleep quality and gastrointestinal motility function after surgery: A prospective, randomized, double-blind, and controlled trial

作者：Sui, Xin; Wang, Yue; Jin, Mingxin; Li, Kun; Jiang, Ge; Song, Ailing; He, Zhaoyi; Yin, Chengke; Zhao, Jingshun; Wang, Liping; Han, Fei^*

来源：Frontiers in Pharmacology, 2022, 13: 990358.

DOI：10.3389/fphar.2022.990358

• dexmedetomidine
• patient-controlled analgesia
• postoperative sleep quality
• postoperative gastrointestinal motility function
• colorectal cancer surgery

Background: Postoperative poor sleep quality and decreased gastrointestinal motility function are common clinical problems. This study investigated the effects of dexmedetomidine (DEX) combined with sufentanil for patient-controlled analgesia (PCA) on postoperative sleep quality and gastrointestinal motility function after surgery in patients with colorectal cancer.Methods: Patients undergoing colorectal cancer surgery were randomly divided into three groups, DEX 0, 200, or 400 mu g, each combined with sufentanil 150 mu g for PCA immediately after surgery. The primary outcome was sleep quality in the first 7 days after surgery based on the Athens Insomnia Scale (AIS) score. The secondary outcome was postoperative gastrointestinal motility recovery evaluated by the time of first flatus, first feces and first diet. Postoperative pain intensity, side effects and the length of postoperative hospital stay were also compared among groups. The study was registered with the Chinese Clinical Trial Registry (, ChiCTR2000032601).Results: Ultimately, 210 cases were included. Sleep quality was better in the DEX 200 mu g group and DEX 400 mu g group than in the DEX 0 mu g group. Overall, in the DEX 200 mu g group and DEX 400 mu g group, the AIS score (p < 0.05) and the incidence of sleep disturbance (7.3%, 4.5% vs. 19.6%, p < 0.001) were lower than those in the DEX 0 mu g group in the first 7 days after surgery. There were no significant differences in postoperative gastrointestinal motility among the three groups in the total surgical categories (p > 0.05). In the laparoscopic surgery patients of each group, the time of postoperative first flatus (p = 0.02) and first feces (p = 0.01) was significantly longer in the DEX 400 mu g group than in the DEX 0 mu g group. There were no differences in postoperative pain intensity, side effects or length of postoperative hospital stay (p > 0.05).Conclusion: The continuous infusion of DEX (200 or 400 mu g) for PCA significantly improved postoperative sleep quality after colorectal cancer surgery. DEX (200 mu g) was better at improving postoperative sleep quality without affecting gastrointestinal motility function than DEX (400 mu g) in patients who underwent laparoscopic colorectal cancer surgery.

• 单位
  同济大学; 中国医学科学院; 哈尔滨医科大学