Effect of preoperative sleep disturbance on efficacy of postoperative analgesia and comfort in patients undergoing colorectal cancer resection surgery / 中国基层医药

ABSTRACT

Objective To evaluate the effect of preoperative sleep disturbance on efficacy of postoperative analgesia and comfort in patients undergoing colorectal cancer resection surgery.Methods 60 colorectal cancer patients with elective anesthesia laparoscopic radical resection were selected.According to the presence or absence of preoperative sleep disorders,they were divided into the sleep disorder group (group A) and non-sleep disorders group (group B),30 patients in each group.Two groups of patients used the same method to maintain anesthesia induction.Intraoperative intravenous nicardipine controlled hypotension in parallel to maintain MAP 60-75mmHg,HR 65-95times/min.The patients received PCIA pump at the end of surgery.Postoperative 24h VAS scores were maintained VAS score ≤3 points,when VAS score ＞ 3 points,given the pressing PCA analgesia remedy.The remedy situation within 24 hours after surgery and comfort analgesic score were recorded.Results Compared with group B,postoperative PCIA pressing number of group A significantly increased [A group(11 ± 5),group B(6 ± 5),t =2.44,P ＜ 0.05].At the end of surgery,postoperative 2h,4h,8h pain scores of group A were (2.8 ± 0.4),(2.5 ± 0.7),(3.2 ± 0.6),(3.5 ± 0.5),respectively,which were significantly higher than those of group B [(1.8 ± 0.5) points,(1.8 ± 0.4) points,(1.9 ± 0.3) points,(2.9 ± 0.3) points; at the end of surgery t =5.78,postoperative 2h t =4.56,postoperative 4h t =4.17,postoperative 8h t =2.09,all P ＜ 0.05],but postoperative 12h,24h had no significant change in pain scores (P ＞ 0.05).Compared with group B,the comfort scores of A group at the end of surgery,postoperative 2h,4h,8h,12h[group A(2.8 ±0.3) points,(2.5 ±0.9)points,(2.6 ±0.9) points,(2.5 ±0.5) points,(2.9 ± 0.6) points ; group B(3.8 ± 0.4) points,(3.3 ± 0.5) points,(3.6 ± 0.8) points,(3.3 ± 0.3) points,(3.3 ± 0.6) points] were significantly lower (at the end of surgery t =9.87 ; postoperative 2h t =4.94 ; postoperative 4h t =6.87 ; postoperative 8h t =7.61 ; postoperative 12h t--2.79,all P ＜ 0.05),after 24h comfort score had no significant change (P ＞ 0.05).Conclusion Preoperative sleep disorders can affect laparoscopic colorectal cancer after radical surgery analgesia and comfort of patients.