Abstract
Methods A prospective, randomized study was conducted with 88 patients undergoing laparoscopic colorectal surgery. The experimental group (S group, n = 44) was given 10 mg of zolpidem tartrate one night before the surgical procedure, while no medication was given to the control group (C group, n = 44). The primary outcome was the intraoperative remifentanil consumption. Sufentanil consumption, average patient-controlled analgesia (PCA) effective press times, the visual analog scale (VAS) scores, and incidences of postoperative nausea and vomiting (PONV) were recorded at 6 h (T1), 12 h (T2), and 24 h (T3) postoperatively. Results The intraoperative remifentanil consumption was significantly lower in the S group than that in the C group (p < 0.01). Sufentanil consumption at 6 h and 12 h postoperatively was significantly lower in the S group than that in the C group (p < 0.05); average PCA effective press times and VAS scores, at 6 h and 12 h postoperatively, were significantly lower in the S group than those in the C group (p < 0.01); differences between groups 24 h postoperatively were not significant. No significant between-group difference was noted in the incidence of nausea and vomiting. Conclusion Improving patients' sleep quality the night before surgical procedure by zolpidem can decrease the usage of intraoperative analgesics and reduce postoperative pain.
Highlights
Colorectal cancer, with a 5-year survival rate of 32%, is the fifth leading cause of death in the Chinese population [1]
Two cases were eliminated due to poor electrode-skin contact or noise interference, and another three cases were excluded due to transfer to the ICU
A significant difference was found in the Leeds Sleep Evaluation Questionnaire (LSEQ) scores on the morning of the surgical procedure. e sleep quality in the S group was improved after administration of zolpidem
Summary
Colorectal cancer, with a 5-year survival rate of 32%, is the fifth leading cause of death in the Chinese population [1]. It can lead to poor sleep quality [10], which is considered a risk factor for many conditions, including cardiovascular disease, dementia, obesity, diabetes, depression, pain, and mortality [11,12,13,14,15]. Recent progress has been made in the study of the relationship between preoperative sleep quality and postoperative pain [16,17,18,19]. E aim of this prospective, randomized, single-center study was to evaluate the effect of improving preoperative sleep quality on perioperative pain by administering zolpidem. We hypothesized that administration of zolpidem the night before the procedure would improve preoperative sleep quality, reduce intraoperative anesthetic medication, and contribute to postoperative pain relief
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