Dexmedetomidine Plus Stellate Ganglion Block Improves Postoperative Sleep Quality in Elderly Hip Arthroplasty...

To investigate the effect of dexmedetomidine combined with stellate ganglion block (SGB) on postoperative sleep quality in elderly patients undergoing hip arthroplasty.

126 patients aged ≥ 65 years undergoing hip arthroplasty were allocated to three groups: control (Group C), dexmedetomidine (Group D), and dexmedetomidine plus SGB (Group DS). Group D received dexmedetomidine (loading dose 0.5µg/kg over 10 min, then 0.2µg/kg/h infusion until surgery end). Group DS received the same regimen plus SGB at C6 with 5mL of 0.375% ropivacaine. The primary outcome was postoperative sleep quality assessed by the Richards-Campbell Sleep Questionnaire (RCSQ) on the first three postoperative nights. Secondary outcomes included postoperative visual analogue scale (VAS) scores, number of patient-controlled analgesia (PCA) and sleep quality using Pittsburgh Sleep Quality Index (PSQI) scores at one month postoperatively.

On the first three postoperative nights (POD 1-3), the RCSQ scores were significantly higher in Groups D and DS compared with Group C (P < 0.001). Specifically, Group D had significantly lower RCSQ scores than Group DS at each postoperative time point (POD 1: mean difference = -6.912, 95% CI: -9.328 to -3.385; POD 2: mean difference = -8.425, 95% CI: -11.464 to -5.386; POD 3: mean difference -8.236, 95% CI: -12.144 to -5.406; P < 0.001). VAS scores on POD 1 and POD 2 were significantly lower in Group DS than in Groups D and C (P < 0.001). No significant differences in PSQI scores were found among the three groups at one month postoperatively (P > 0.05).

In elderly patients undergoing hip arthroplasty, dexmedetomidine combined with SGB significantly improved subjective sleep quality during the first three postoperative nights, although this beneficial effect was not maintained at one month postoperatively.