药物治疗对术后睡眠质量的影响:对随机对照试验的系统审查
Jinny Tsang1,2, Jasmine Kang3, Nina Butris2,4
1Department of Immunology, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Journal of anaesthesiology, clinical pharmacology
|March 3, 2025
概括
术后的药理疗法,包括德克斯梅托米丁和某些阿片类药物,可以改善术后的睡眠质量. 这些治疗也可以减少疼痛和阿片类药物消费,帮助患者康复.
科学领域:
- 麻醉学 麻醉学
- 睡眠医学 睡眠医学
- 药理学 药理学是指药理学的学科.
背景情况:
- 手术后睡眠障碍会对患者的康复产生负面影响,并增加并发症风险.
- 优化睡眠对于有效的术后护理和愈合至关重要.
- 正在探索药理干预措施来管理手术后的睡眠障碍.
研究的目的:
- 系统地审查术后药理疗法对术后睡眠质量的影响.
- 评估各种药物类别在改善住院手术患者睡眠结果方面的疗效.
- 评估对疼痛和阿片类药物消费的影响作为次要结果.
主要方法:
- 从多个数据库 (MEDLINE,Embase,Cochrane) 来进行随机对照试验 (RCT) 的系统审查,直到2023年8月.
- 包括经历手术后睡眠问题的非心脏手术患者 (≥18岁).
- 主要结果:改善睡眠质量,持续时间,效率,结构和失眠;次要结果:疼痛评分和阿片类药物使用.
主要成果:
- 在21项研究中的18项 (n=3276) 报告说,药物治疗改善了睡眠结果.
- 德克斯梅德托米丁,阿片类药物 (纳尔布芬,特拉马多尔/苏芬塔尼尔),非阿片类药物 (佐尔皮德姆,米达佐拉姆,普雷加巴林),TIVA的普罗波福,S-胺和罗皮瓦卡因阻断了睡眠质量.
- 组合治疗 (例如,德克斯梅托米丁与阿片类药物) 改善了疼痛和睡眠,德克斯梅托米丁减少了阿片类药物的消费.
结论:
- 有限证据表明外科手术期间对手术后睡眠的药理学影响.
- 几种药物在改善睡眠质量和减少手术后疼痛方面表现有前途.
- 需要高质量的RCT来进一步确定这些干预措施的有效性和安全性.
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