南方医科大学学报2026，Vol.46Issue(6)：1228-1234,7.DOI:10.12122/j.issn.1673-4254.2026.06.03
术中应用右美托咪定对老年患者术后睡眠障碍的影响:一项前瞻性多中心队列研究
Effect of intraoperative dexmedetomidine on postoperative sleep disturbance in elderly surgical patients:a prospective multicenter cohort study
摘要
Abstract
Objective To investigate the association between intraoperative dexmedetomidine administration and postoperative sleep disturbance in elderly patients undergoing noncardiac surgeries.Methods This prospective observational study included patients aged≥65 years undergoing noncardiac surgeries between April,2020 and April,2022 in multiple hospitals.The primary outcome was the incidence of postoperative sleep disturbance within 3 days after surgery,assessed using the Sleep Quality-Numeric Rating Scale.The secondary outcomes included the incidences of sleep disturbance on the night of surgery and two subsequent nights,postoperative severe pain,postoperative delirium,acute kidney injury,stroke and pulmonary infection.Univariate and multivariate logistic regression analyses were conducted to explore the relationship between dexmedetomidine and postoperative sleep disturbance.Propensity score matching was used to balance the baseline characteristics,and subgroup analyses were performed to explore the association between dexmedetomidine and postoperative sleep disturbance.Results Among the 5245 patients,1352(25.78%)developed postoperative sleep disturbance within 3 days after surgery.The incidence of postoperative sleep disturbance was significantly lower in dexmedetomidine group than in the non-dexmedetomidine group(unadjusted:21.0%vs 27.9%,P<0.001;PSM:20.7%vs 25.4%,P<0.001).Dexmedetomidine was significantly associated with a reduced risk of postoperative sleep disturbance(unadjusted:OR=0.69,95%CI:0.60-0.79,P<0.001;Model I:OR=0.76,95%CI:0.66-0.87,P<0.001;Model II:OR=0.75,95%CI:0.65-0.87,P<0.001;PSM:OR=0.77,95%CI:0.65-0.91,P<0.001),and the association remained significant in subgroup analyses for gender,ASA classification,surgery duration,and surgical types).The incidences of severe postoperative pain,postoperative delirium and pulmonary infection were all significantly lower in dexmedetomidine group.Conclusion Intraoperative dexmedetomidine administration is associated with reduced postoperative sleep disturbance in elderly patients undergoing noncardiac surgery and lowers the incidences of severe postoperative pain,postoperative delirium and pulmonary infections.关键词
右美托咪定/术后睡眠障碍/老年患者/非心脏手术Key words
dexmedetomidine/postoperative sleep disturbance/elderly patients/noncardiac surgery引用本文复制引用
孟冰冰,曹江北,米卫东,李皓,刘畅,廖国松,张凯,杨木泽,顾娟娟,娄景盛,刘艳红,傅强..术中应用右美托咪定对老年患者术后睡眠障碍的影响:一项前瞻性多中心队列研究[J].南方医科大学学报,2026,46(6):1228-1234,7.基金项目
国家重点研发计划(2018YFC2001900) （2018YFC2001900）
