The effect of opioid-free anesthesia on postoperative sleep and recovery quality in patients undergoing snoring surgery
Objective To evaluate the effect of opioid-free anesthesia(OFA)on postoperative sleep and recovery quality in pa-tients undergoing snoring surgery.Methods A total of 120 patients,aged 18-45 years,with a body mass index(BMI)of 28-45 kg/m2 and American Society of Anesthesiologists(ASA)level Ⅰ-Ⅲ,who underwent snoring surgery at the Changde Hospital,Xiangya School of Medicine,Central South University from January 2023 to January 2024 were selected.They were divided into an OFA group(OF group)and a control group(C group)by using a random number table method,with 60 patients in each group.The dexmedetomidine,es-ketamine,lidocaine,propofol,and rocuronium were used for induction,while esketamine,dexmedetomidine,and sevoflurane for main-tenance in the OF group;the sufentanil,propofol,and rocuronium were used for induction,while remifentanil and sevoflurane for main-tenance in the C group.The patient's postoperative sleep and recovery qualities were evaluated by using the Pittsburgh sleep quality in-dex(PSQI)scores and 15-item Quality of Recovery(QoR-15)scales on the first morning before surgery(D-1),the first day after surgery(D1),and the third day after surgery(D3).The patients wore a sport-watch 2 nights before surgery(N-2),on the night after surgery(N0),and the second night after surgery(N2)for recording the sleep quality.The patient's general surgical information,including heart rate,mean arterial pressure(MAP),pulse oxygen saturation(SpO2),bispectral index(BIS)were recorded at the time points before anesthesia induction(T0),before tracheal intubation(T1),immediately after tracheal intubation(T2),at the beginning of surgery(T3),at awakening(T4),and 10 minutes after awakening(T5).The resting and exercise Numerical Rating Scale(NRS)pain scores for D1,the second day af-ter surgery(D2),and D3.Postoperative adverse reactions and patient satisfaction were also recorded and analyzed.Results Com-pared with N_2,patients of both groups showed an increase in sleep time and sleep efficiency,a decrease in awake time after falling asleep on N0 and N2(all P＜0.05),and a prolonged sleep latency on N0(P＜0.05).Compared with D-1,both groups of patients had a de-crease in PSQI scores on D,and D3(all P＜0.05),and a decrease in QoR-15 scores at D,(P＜0.05).Compared with T0,the heart rate in-creased at T2(P＜0.05),the MAP decreased at T3(P＜0.05),and BIS decreased at T1-T3(all P＜0.05)in the OF group;the heart rate de-creased at T,and T3(all P＜0.05),MAP decreased at T1-T3(all P＜0.05),and BIS decreased at T1-T4(all P＜0.05)in the C group.Com-pared with C group,OF group had longer sleep time,higher sleep efficiency,shorter sleep latency,and shorter awakening time after fall-ing asleep at N0(all P＜0.05);the PSQI score was low and the QoR-15 score was high on D,(all P＜0.05);the heart rate was fast at T1-T2(all P＜0.05),and MAP was high at T1-T3(all P＜0.05);the NRS pain score was low on D,and D2(all P＜0.05);while the incidence of nausea and vomiting was low,and the patient satisfaction score was high(all P＜0.05).There was no statistical difference in other indica-tors between the two groups(all P＞0.05).Conclusions OFA can improve the postoperative sleep and recovery quality of patients undergoing snoring surgery and increase patient satisfaction rate.
NETL
NSTL
万方数据
