术前右美托咪定喷鼻对失眠症患者术前睡眠质量的影响

The Effect of Preoperative Dexmedetomidine Nasal Spray on Preoperative Sleep Quality in Patients with Insomnia

摘要: 目的：本试验旨在探究术前右美托咪定(Dexmedetomidine, Dex)喷鼻对失眠症患者术前睡眠质量的影响，为术前不良睡眠提供临床治疗依据。方法：选择2023年03月~2023年06月期间，在我院择期行甲状腺全部或部分切除术且符合纳入排除标准的失眠症患者60例，使用计算机生成的随机数表将受试者分为两组：右美托咪定组和生理盐水组，每组均有30名受试者，并采用双盲原则。术前一晚21:00时，干预组(Dex组)给予右美托咪定1.5 μg/kg喷鼻，对照组(NS组)给予0.01 mL/kg生理盐水喷鼻。在入院当晚及术前一晚使用睡眠监测仪记录客观睡眠质量，包括睡眠效率、入睡潜伏期、总睡眠时间等睡眠参数。同时记录了术前一晚干预后发生的不良反应和进入手术室时的血流动力学指标。结果：两组患者的一般特征和临床特征(年龄、性别、BMI、ASA分级、合并症、手术持续时间、麻醉持续时间、清扫淋巴结、甲状腺部分或全部切除术)无统计学差异(P > 0.05)。睡眠监测仪的客观睡眠质量结果：与NS组患者相比，Dex组患者术前一晚的睡眠效率明显提高，入睡潜伏期缩短，并延长了总睡眠时间(P < 0.05)。血流动力学指标结果：与NS组患者相比，Dex组患者进入手术室后血流动力学指标更稳定(P < 0.05)。结论：术前一晚1.5 μg/kg右美托咪定喷鼻安全有效，可改善失眠症患者术前一晚的睡眠障碍。

Abstract: Purpose: This experiment aims to investigate preoperative dexmedetomidine (Dexmedetomidine), the effect of Dex nasal spray on preoperative sleep quality in patients with insomnia, providing clinical treatment basis for preoperative poor sleep. Method: Sixty insomnia patients who underwent elective total or partial thyroidectomy in our hospital from March 2023 to June 2023 and met the inclusion and exclusion criteria were selected. The subjects were divided into two groups using a computer-generated random number table: the dexmedetomidine group and the saline group, with 30 subjects in each group, and the double-blind principle was adopted. At 21:00 the night before surgery, the intervention group (Dex group) was given 1.5 μg/kg dexmedetomidine nasal spray, while the control group (NS group) was given 0.01 mL/kg physiological saline nasal spray. On the night of admission and the night before surgery, use a sleep monitor to record objective sleep quality, including sleep efficiency, sleep latency, total sleep time, and other sleep parameters. At the same time, adverse reactions that occurred after the intervention one night before surgery and hemodynamic indicators upon entering the operating room were recorded. Result: General and clinical characteristics (age, gender There was no statistically significant difference (P > 0.05) in BMI, ASA grading, comorbidities, surgical duration, anesthesia duration, lymph node dissection, and partial or total thyroidectomy. Objective sleep quality results of sleep monitors: Compared with patients in the NS group, the sleep efficiency of the Dex group patients significantly improved the night before surgery, with a shortened sleep latency and an extended total sleep time (P < 0.05). Hemodynamic index results: Compared with NS group patients, the hemodynamic indicators of Dex group patients were more stable after entering the operating room (P < 0.05). Conclusion: The 1.5 μg/kg dexmedetomidine nasal spray one night before surgery is safe and effective, and can improve sleep disorders in patients with insomnia one night before surgery.