Effect of Mini-Dose Esketamine Combined with Dexmedetomidine on Sleep and Recovery in Patients after Radical Breast Cancer Surgery
Objective:To observe the effect of low-dose esketamine combined with dexmedetomidine on postoperative sleep and recovery in patients undergoing radical mastectomy for breast cancer.Methods:90 women aged 30 ～65,BMI 18 ～28 kg/m2 ,ASA physical status Ⅰ ～Ⅲ.Patients were randomly divided into two groups:control group (Group C)and esketamine combined with dexmedetomidine (Group ED),with 45 cases in each group.The induction of anesthesia and anterior serratus plane block were the same in both groups,and PCIA was performed at the end of surgery.Maintenance of anesthesia:Propofol and remifentanil in Group C; and propofol,dexmedetomidine,and esketamine in Group ED,and BIS was maintained at 40 ～60 in both group.Cisatracurium was injected intermittently according to anesthetic depth and intraoperative blood pressure.The watch-type sleep monitor (Actiwatch)and sleep logs were used to record patients'sleep at 1day preoperatively,1 day postoperative and 3days postoperative.The Pittsburgh Sleep Quality Index Scale,Hospital Anxiety and Depression Scale and Qor-40 Scale were used to assess the recovery of the patients,and the incidence of adverse reactions was recorded.Results:Compared with Group C,the total sleep time and sleep efficiency were significantly improved in the Group ED at 1day and 3days postoperatively (P<0.05),the number of nocturnal awakening was low (P< 0.05),the anxiety and depression score in the Group ED at 3 days postoperatively were lower than those in Group C(P<0.05),and the QoR-40 score in Group ED at 3days postoperatively was higher than that in group C (P<0.05 ).Conclusion:Low -dose esketamine combined with dexmedetomidine can relieve the postoperative pain of breast cancer patients,reduce the use of opioid drugs,and improve the quality of postoperative sleep and recovery without increasing the incidence of adverse effects.
Low-dose esketamineSleep disordersPainAnxiety and depression
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维普
