| Purpose: As an essential physiological function of the human body,sleep is of great significance to the self-recovery of the body.Most patients have severe sleep disorders after surgery.This article uses a combination of sleep questionnaire and Actigraphy to discussion on influence from Dexmedetomidine to the sleep of patients who received the Thoracoscope-assisted Radical Resection of Pulmonary Carcinoma.Method: select 62 cases of patients who received the Thoracoscope-assisted Radical Resection of Pulmonary Carcinoma on the appropriate date under general anesthesia in The Zhongshan Hospital of Dalian University from May 2017 to December 2017 as the researching object.Two groups were divided in the method of random numerical table: experimental group(Dexmedetomidine)and control group(0.9% sodium chloride),and 31 cases for each group.0.5?g/kg of loading dose of Dexmedetomidine was given to the experimental group(pumping was finished within 10 minutes)after patients entered the room to establish venous access,pumping continued in the dose of 0.3?g/kg/h until pleural lavage was finished;the control group was infused with the same dose of 0.9% sodium chloride injection on time in the whole process.Two groups were all used with total intravenous anesthesia and connected with the analgesic pump after surgery.Analgesic pump of experimental group: 0.05?g/kg/h of Sulfentanyl + 0.1?g/kg/h of Dexmedetomidine + 0.9% sodium chloride were made to form the solution in 200 ml,the self-controlled dosage was 0.03?g/kg of Sulfentanyl + 0.067?g/kg of Dexmedetomidine;analgesic pump of control group: 0.05?g/kg/h of Sulfentanyl + 0.9% sodium chloride were made to form the solution in 200 ml,the self-controlled dosage was 0.033?g/kg.The Subjective Memory And Sleep Quality Table(subjective method)and the Actigraphy Recording(objective method)were mainly used to judge the sleep time and sleep quality before surgery and on the day of surgery and on the first,second,third,sixth and in 1 month after surgery.In the mean time,VAS scoring,the adverse reaction,the accumulated dosage of Sulfentanyl and the adverse reaction were observed.Result: there was no statistical difference(P>0.05)on comparison of sex,age,weight,BMI,time of surgery and ASA grading for patients in two groups.(2)Sleep time: the subjective and objective sleep time after surgery for patients in two groups all had different extents of reduction comparing to that before surgery,therein,the extent of reduction of experimental group was less than that of control group;but two groups' sleep deprivation all were worst on the day of after surgery;the remaining had prolonged sleep time for a few days after surgery except on the evening of pump withdrawal.The subjective sleep time was generally longer than the objective sleep time for patients in two groups.Subjective sleep time: there was no statistical difference(P>0.05)for patients in two groups one day before surgery;the sleep time of experimental group on the day of after surgery and the first,second and third day after surgery was longer than that of control group,the difference had the meaning of statistics(P<0.05);the sleep time for patients in two groups after surgery was close on the sixth day,the difference had no meaning of statistics(P>0.05).Objective sleep time: there was no statistic meaning on sleep time for patients in two groups one day before surgery(P>0.05);the sleep time of experimental group on the day of after surgery and the first,second and third day after surgery was longer than that of control group,the difference had the meaning of statistics(P<0.05);the sleep time for patients in two groups after surgery was close on the sixth day,the difference had no meaning of statistics(P>0.05).(3)There was no statistic meaning on difference of AIS scoring for patients in two groups one day before surgery(P>0.05): AIS scoring for patients in two groups after surgery increased obviously than that before surgery,the score of experimental group was obviously lower than that of control group on the sixth day after surgery,the difference had the meaning of statistics(P<0.05).(4)There was no statistic meaning on difference of PSQI scoring for experimental group one day before surgery comparing to that after discharging from hospital for one month(P>0.05): there was no statistic meaning on difference of PSQI scoring for control group one day before surgery comparing to that after discharging from hospital for one month(P>0.05): there was no obvious difference on PSQI scoring between one day before surgery and discharging from hospital for one month for patients in two groups(P>0.05).(5)There was no statistic difference on the peak value of VAS scoring between patients in two groups on the day of surgery(P>0.05);two groups' VAS scoring all reduced on the third day after surgery,which had no statistic difference between groups(P>0.05).(6)the accumulated dosages of applying Sulfentanyl for easing pain in and after surgery were recorded,the dosage of Sulfentanyl of experimental group was obviously less than that of control group,which had no statistic meaning for the difference(P<0.05).(7)For the comparison of adverse reaction between patients in two groups after surgery,the cases of causing nausea and vomiting of experimental group were much less than that of control group,but which had no statistic meaning(P>0.05).Conclusion: the sleep of patients who received thoracoscopic surgery will be deprived in a short term.Using Dexmedetomidine in and after surgery can reduce the dosage of the analgesic drug like Sulfentanyl obviously after surgery,and improve the sleep time and sleep quality of patients remarkably in a short term after surgery,which has no obvious influence on long-term sleep after surgery. |
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