Abstract
Postoperative sleep disturbance and fatigue following radical mastectomy were high risks for prolonged convalescence in patients with breast cancer. The present study was designed to observe the effect of intraoperative use of dexmedetomidine on postoperative sleep, fatigue and recovery following radical mastectomy under general anesthesia. Forty-seven patients were randomized into two groups that were maintained with propofol/remifentanil/Ringer’s solution (Control group), or propofol/remifentanil/Dexmedetomidine (DEX group) for surgery under general anesthesia. During the first night following surgery, patients receiving dexmedetomine spent more time sleeping when compared with those form the Control group. During the first week following operation, when compared with the Control group, patients from the DEX group had a higher score of global 40-item recovery questionnaire on day 3 following operation, and lower 9-question fatigue severity scores on day 3 and day 7 following operation. In conclusion, intraoperative use of dexmedetomidine is sufficient to improve postoperative sleep disorder, promote postoperative recovery. The adverse effect of dexmedetomidine on sleep disturbance might be contributed to its recovery-promoting effect.
Highlights
Postoperative sleep disturbance and fatigue are high risk factors to prolonged convalescence and additional hospital costs
The present study have found that general anesthesia maintained with dexmedetomidine improved sleep disturbance and promote recovery following radical mastectomy in patients with breast cancer
The adverse effect of dexmedetomidine on sleep disturbance might be contributed to its recovery-promoting effect
Summary
Postoperative sleep disturbance and fatigue are high risk factors to prolonged convalescence and additional hospital costs. Clinical trials have found that intraoperative use of dexmedetomidine for general anesthesia, a highly selective alpha-2 adrenergic agonist, was able to attenuate postoperative fatigue, promote recovery, facilitate the analgesic property of PCA morphine, reduce morphine consumption as well as its related adverse effects [1,2,3,4,5,6,7,8,9,10,11]. Dexmedetomidine was reported to improve postoperative outcomes in breast cancer patients following operations, such as displaying analgesia-promoting effect on acute and chronic pain [4, 10, 11]. Based on the evidence above, we hypothesized that intraoperative use of dexmedetomidine might promote the sleep quality and recovery in breast cancer patients following radical mastectomy under general anesthesia
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