Effect of Intraoperative Intravenous Infusion of Esketamine Combined with Dexmedetomidine on Postoperative Sleep Disturbance in Patients Undergoing Radical Mastectomy
Xingyu Geng,1,2,* Yutian Pu,1,2,* Ziwei Hu,1,2 Heling Zhang,1,2 Maosan Wang,1,2 Can Fang,1,2 Gaochao Lv,1,2 Wanting Li,1,2 Xinyue Zhang,1,2 Xiaoxuan Fan,1,2 Su Liu,1,2 Xiuxia Chen,1,2 Jingru Wu1,2 1Department of Anesthesiology, the Affiliated Hospital of Xuzhou Medical Univer...
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2025-05-01
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| author | Geng X Pu Y Hu Z Zhang H Wang M Fang C Lv G Li W Zhang X Fan X Liu S Chen X Wu J |
| author_facet | Geng X Pu Y Hu Z Zhang H Wang M Fang C Lv G Li W Zhang X Fan X Liu S Chen X Wu J |
| author_sort | Geng X |
| collection | DOAJ |
| description | Xingyu Geng,1,2,* Yutian Pu,1,2,* Ziwei Hu,1,2 Heling Zhang,1,2 Maosan Wang,1,2 Can Fang,1,2 Gaochao Lv,1,2 Wanting Li,1,2 Xinyue Zhang,1,2 Xiaoxuan Fan,1,2 Su Liu,1,2 Xiuxia Chen,1,2 Jingru Wu1,2 1Department of Anesthesiology, the Affiliated Hospital of Xuzhou Medical University, Xuzhou Medical University, Xuzhou, People’s Republic of China; 2Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xiuxia Chen, Department of Anesthesiology, the Affiliated Hospital of Xuzhou Medical University, No. 99 huaihai West Road, Xuzhou, Jiangsu, 221002, People’s Republic of China, Tel +86-15205200798, Email cxxlxy@sina.com Jingru Wu, Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China, Email wujingr5810@sina.comObjective: Postoperative sleep disturbance(POSD) is a problem in breast cancer patients after surgery. Little is known about the differences in the treatment of POSD with esketamine combined with dexmedetomidine under the same circumstances. We investigated the effects of intraoperative esketamine combined with intravenous dexmedetomidine on the incidence of POSD and postoperative sleep architecture.Methods: A single-center, randomized, double-blind controlled trial was conducted. A total of 100 participants were randomly assigned to four groups: the esketamine group (Group E), the dexmedetomidine group (Group D), the esketamine combined with dexmedetomidine group (Group ED), and the control group (Group S) (n=25 each). The intervention drugs were continuously infused until the placement of the drainage tube. The primary outcome measure was the incidence of POSD, defined as an Athens Insomnia Scale (AIS) score > 6 on at least one of the first three postoperative days. The secondary outcome measure was the duration of sleep structure, which was collected using the Fitbit Charge 2® smartwatch (Fitbit, Inc. San Francisco, California, USA).Results: In the first three postoperative days, the incidence of POSD was similar across the four groups (P=0.947). However, on postoperative day 3 (POD3), there was a significant interaction between esketamine and dexmedetomidine (P=0.004). Further simple effect analysis revealed that, in the absence of esketamine, dexmedetomidine had a significant effect on POSD on POD3 (OR=0.196, [0.056– 0.691]; P=0.019). In the absence of dexmedetomidine, esketamine had a significant effect on POSD on POD3 (OR=0.248, [0.074– 0.833]; P=0.042). Dexmedetomidine reduced rapid eye movement (REM) sleep on postoperative day 1 (P=0.042). Esketamine reduced nighttime awakening time on POD1 (P=0.036) and POD3 (P=0.020).Conclusion: Intraoperative infusion of esketamine combined with dexmedetomidine had no significant effect on POSD, but dexmedetomidine reduced REM sleep, and esketamine reduced the nocturnal awakening time.Keywords: breast cancer, sleep disturbance, esketamine, dexmedetomidine |
| format | Article |
| id | doaj-art-96c8c02f1d884797bae822de82f87918 |
| institution | Kabale University |
| issn | 1177-8881 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Drug Design, Development and Therapy |
| spelling | doaj-art-96c8c02f1d884797bae822de82f879182025-08-20T03:32:36ZengDove Medical PressDrug Design, Development and Therapy1177-88812025-05-01Volume 19Issue 146294640103489Effect of Intraoperative Intravenous Infusion of Esketamine Combined with Dexmedetomidine on Postoperative Sleep Disturbance in Patients Undergoing Radical MastectomyGeng X0Pu Y1Hu Z2Zhang H3Wang M4Fang C5Lv GLi W6Zhang XFan XLiu S7Chen X8Wu J9Department of AnesthesiologyDepartment of AnesthesiologyDepartment of AnesthesiologySpinal surgeryDepartment of AnesthesiologyxzmuBoai streetDepartment of AnesthesiologyAnesthesiologyJiangsu Province Key Laboratory of AnesthesiologyXingyu Geng,1,2,* Yutian Pu,1,2,* Ziwei Hu,1,2 Heling Zhang,1,2 Maosan Wang,1,2 Can Fang,1,2 Gaochao Lv,1,2 Wanting Li,1,2 Xinyue Zhang,1,2 Xiaoxuan Fan,1,2 Su Liu,1,2 Xiuxia Chen,1,2 Jingru Wu1,2 1Department of Anesthesiology, the Affiliated Hospital of Xuzhou Medical University, Xuzhou Medical University, Xuzhou, People’s Republic of China; 2Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xiuxia Chen, Department of Anesthesiology, the Affiliated Hospital of Xuzhou Medical University, No. 99 huaihai West Road, Xuzhou, Jiangsu, 221002, People’s Republic of China, Tel +86-15205200798, Email cxxlxy@sina.com Jingru Wu, Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China, Email wujingr5810@sina.comObjective: Postoperative sleep disturbance(POSD) is a problem in breast cancer patients after surgery. Little is known about the differences in the treatment of POSD with esketamine combined with dexmedetomidine under the same circumstances. We investigated the effects of intraoperative esketamine combined with intravenous dexmedetomidine on the incidence of POSD and postoperative sleep architecture.Methods: A single-center, randomized, double-blind controlled trial was conducted. A total of 100 participants were randomly assigned to four groups: the esketamine group (Group E), the dexmedetomidine group (Group D), the esketamine combined with dexmedetomidine group (Group ED), and the control group (Group S) (n=25 each). The intervention drugs were continuously infused until the placement of the drainage tube. The primary outcome measure was the incidence of POSD, defined as an Athens Insomnia Scale (AIS) score > 6 on at least one of the first three postoperative days. The secondary outcome measure was the duration of sleep structure, which was collected using the Fitbit Charge 2® smartwatch (Fitbit, Inc. San Francisco, California, USA).Results: In the first three postoperative days, the incidence of POSD was similar across the four groups (P=0.947). However, on postoperative day 3 (POD3), there was a significant interaction between esketamine and dexmedetomidine (P=0.004). Further simple effect analysis revealed that, in the absence of esketamine, dexmedetomidine had a significant effect on POSD on POD3 (OR=0.196, [0.056– 0.691]; P=0.019). In the absence of dexmedetomidine, esketamine had a significant effect on POSD on POD3 (OR=0.248, [0.074– 0.833]; P=0.042). Dexmedetomidine reduced rapid eye movement (REM) sleep on postoperative day 1 (P=0.042). Esketamine reduced nighttime awakening time on POD1 (P=0.036) and POD3 (P=0.020).Conclusion: Intraoperative infusion of esketamine combined with dexmedetomidine had no significant effect on POSD, but dexmedetomidine reduced REM sleep, and esketamine reduced the nocturnal awakening time.Keywords: breast cancer, sleep disturbance, esketamine, dexmedetomidinehttps://www.dovepress.com/effect-of-intraoperative-intravenous-infusion-of-esketamine-combined-w-peer-reviewed-fulltext-article-DDDTbreast cancersleep disturbanceesketaminedexmedetomidine |
| spellingShingle | Geng X Pu Y Hu Z Zhang H Wang M Fang C Lv G Li W Zhang X Fan X Liu S Chen X Wu J Effect of Intraoperative Intravenous Infusion of Esketamine Combined with Dexmedetomidine on Postoperative Sleep Disturbance in Patients Undergoing Radical Mastectomy Drug Design, Development and Therapy breast cancer sleep disturbance esketamine dexmedetomidine |
| title | Effect of Intraoperative Intravenous Infusion of Esketamine Combined with Dexmedetomidine on Postoperative Sleep Disturbance in Patients Undergoing Radical Mastectomy |
| title_full | Effect of Intraoperative Intravenous Infusion of Esketamine Combined with Dexmedetomidine on Postoperative Sleep Disturbance in Patients Undergoing Radical Mastectomy |
| title_fullStr | Effect of Intraoperative Intravenous Infusion of Esketamine Combined with Dexmedetomidine on Postoperative Sleep Disturbance in Patients Undergoing Radical Mastectomy |
| title_full_unstemmed | Effect of Intraoperative Intravenous Infusion of Esketamine Combined with Dexmedetomidine on Postoperative Sleep Disturbance in Patients Undergoing Radical Mastectomy |
| title_short | Effect of Intraoperative Intravenous Infusion of Esketamine Combined with Dexmedetomidine on Postoperative Sleep Disturbance in Patients Undergoing Radical Mastectomy |
| title_sort | effect of intraoperative intravenous infusion of esketamine combined with dexmedetomidine on postoperative sleep disturbance in patients undergoing radical mastectomy |
| topic | breast cancer sleep disturbance esketamine dexmedetomidine |
| url | https://www.dovepress.com/effect-of-intraoperative-intravenous-infusion-of-esketamine-combined-w-peer-reviewed-fulltext-article-DDDT |
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