The Influence Of Preoperative Sleep Disturbance On The Waking Quality Of Patients Undergoing General Anesthesia

Objective : Many studies have shown that sleep disorders are correlated with pathogenesis and development of various diseases.Because of disease itself,anxiety,environment and treatments,perioperative patients are more likely to sleep disorders.Previous studies paid attention to the influence of postoperative sleep quality on the prognosis of patients,but few reports on the influence of preoperative sleep quality on outcomes.Recovery form anesthesia is one of the key point in general anesthesia management.Patients in this period are vulnerable to suffer from restlessness,delirium,nausea and vomiting and other adverse events,affecting the prognosis of patients.Whether the quality of recovery was influenced by preoperative sleep quality or not needs to be advanced study.The purpose of present study was to investigate the sleep status of perioperative patients,explore the effects on quality of recovery from anesthesia and illustrate the correlation between them,in order to provide theoretical guidance for clinical treatment.Methods: Patients with aged above 18 years old,ASA I-III,who underwent surgical procedure with general anesthesia and admitted to PACU postoperative,were included in this study.Those who were unable to complete the scale due to mental illness and taking psychotropic drugs for a long time were excluded.Preoperative visit was conducted one day before the operation to understand the medical history,and the sleep status of the patients.The sleep quality was assessed by Pittsburgh sleep scale(PSQI).On the day of surgery,the patient was routinely induced by general anesthesia and admitted to PACU when the drugs were discontinued after surgery.The main outcomes included PSQI score,time to eye opening,PACU length of stay and 15 min,30 min Steward scores after extubation.The secondary outcomes were the occurrence of nausea and vomiting,Hypoxemia,delayed recovery and other complications.Results: In total,545 patients were enrolled.Of which,404(74.14%)patients were sleep disorder(PSQI?5)and 141(25.87%)patients with non-sleep disorder.The PSQI score was respectively 7.07�1.63 and 3.1631�0.99 in sleep disorder group and non-sleep disorder group.The results of univariate analysis showed that there was no significant difference between both groups in height,weight,job category,comorbidity,operation time and surgery type(P>0.05),but there was significant difference in age,gender and education level(P<0.05).The results of Logistic regression analysis also showed that perioperative sleep disorder was correlated with age,gender and education level(P<0.05),but not correlated with weight,height,comorbidity,and surgical type(P>0.05).Compared with the non-sleep disorder group,patients in sleep disorder group has a longer time to eye opening(22.80�14.43 vs 19.82�10.96,P<0.05),PACU length of stay(48.53�22.09 vs 37.95�12.93,P<0.05)and had a decreased 15 min Steward score(3.86�3.90 vs 4.61�3.78)and 30 min Steward score(4.41�2.19 vs 5.35�2.81,P<0.05).In the risk of complications,patiens in sleep disorder group had a higher total incidence of postoperative complications than non-sleep disorder group(15.84% vs.12.06%,P < 0.01).Conclusion: The sleep disorder in perioperative patients are corrected with age,gender and education level;preoperative sleep disorder could influence quality of recovery from anesthesia increasing the risk of postoperative adverse enents.