Effects Of Sub-Anesthetic Dose Of Esketamine On Postoperative Sleep Quality Of Patients Undergoing Total Hysterectomy

Objective:To investigate the effect of preoperative sub-anesthetic dose of esketamine on postoperative sleep in patients undergoing laparoscopic total hysterectomy and its possible mechanism.。Methods:A total of 106 patients who underwent laparoscopic total hysterectomy under general anesthesia in the First Hospital of Shanxi Medical University from October 2021 to May2022 were selected.The selected patients were divided into esketamine group and control group by random number table method.Group of 53 cases.The patients in the esketamine group were given 0.3 mg/kg esketamine before surgical incision.The Pittsburgh Sleep Quality Index(PSQI)and the Self-Rating Depression Scale(SDS)were used to evaluate the sleep quality and depressive state of the patients 1 day before surgery,on the day of surgery and 2 days after surgery,respectively.Use a wearable smart bracelet to record the patient’s sleep duration.The Numerical Rating Scale(NRS)and opioid consumption were recorded 4 hours and 48 hours after the operation.The incidence of intraoperative and postoperative adverse reactions was recorded.Results:There was no significant difference in preoperative PSQI score,SDS score,sleep duration and number of awakenings between the two groups(P>0.05).The postoperative PSQI score,SDS score and number of awakenings in the esketamine group [7.90±3.02,30.32±8.15,3(2.25)] were lower than those in the control group [10.94±4.08,38.79±9.59,4(2)](P<0.05);postoperative total sleep duration and deep sleep duration(357.54±62.98,93.62±30.17)in the esketamine group were more than those in the control group(316.15±59.26,63.65±21.47)(P<0.05);patients in the esketamine group The postoperative NRS score and opioid dosage [2(1),82.16±4.53] were lower than those of the control group [2(2),88.50±4.28](P<0.05);intraoperative and postoperative adverse reactions of the two groups The incidence rate was not statistically significant(P>0.05).Conclusion:The subanesthetic dose of ketamine before operation can improve the sleep structure,prolong the sleep time and improve the sleep quality of patients with laparoscopic hysterectomy,reduce postoperative pain and the dosage of analgesics It is helpful to adjust the patients’ mood and improve their anxiety,and does not increase the incidence of adverse reactions during and after operation.