Drug Design, Development and Therapy (Jun 2023)
Dexmedetomidine Improved Sleep Quality in the Intensive Care Unit After Laryngectomy
Abstract
Jingjing Huang,1,2,* Minju Qin,3,* Weisha Lu,3 Xia Shen3 1ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital of Fudan University, Shanghai, People’s Republic of China; 2Shanghai Municipal Key Clinical Specialty, Eye & ENT Hospital of Fudan University, Shanghai, People’s Republic of China; 3Department of Anesthesiology, Eye & ENT Hospital of Fudan University, Shanghai, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xia Shen, Department of Anesthesiology, Eye & ENT Hospital of Fudan University, Fenyang Road No. 83, Xuhui District, Shanghai, People’s Republic of China, Tel +86-13611874118, Fax +86-21-64373416, Email [email protected]: To examine whether nighttime dexmedetomidine infusion improved sleep quality in patients after laryngectomy.Patients and Methods: Thirty-five post-laryngectomy patients admitted to the intensive care unit (ICU) were randomly assigned to a 9-h (from 2100 h on surgery day to 0600 h the morning after laryngectomy) dexmedetomidine (0.3 μg/kg/h continuous infusion) or placebo group. Polysomnography results were monitored during the dexmedetomidine infusion period. The percentage of stage 2 non-rapid eye movement (stage N2) sleep was the primary outcome measure.Results: Thirty-five patients (18 placebo group; 17 dexmedetomidine group) had complete polysomnogram recordings. The percentage of stage N3 sleep was significantly increased in the dexmedetomidine infusion group (from median 0% (0 to 0) in placebo group to 0% (interquartile range, 0 to 4) in dexmedetomidine group (difference, − 2.32%; 95% CI, − 4.19 to − 0.443; P = 0.0167)). Infusion had no effect on total sleep time, stage N1 or N2 sleep percentages, or sleep efficiency. It decreased muscle tensity and snore non-rapid eye movement. Subjective sleep quality improved. Hypotension incidence increased in the dexmedetomidine group, but significant intervention was not required.Conclusion: Dexmedetomidine infusion improved overall patient sleep quality in the ICU after laryngectomy.Keywords: dexmedetomidine infusion, postoperative, polysomnography, sleep disordered
