Dexmedetomidine Improves Non-rapid Eye Movement Stage 2 Sleep in Children in the Intensive Care Unit on the First Night After Laparoscopic Surgery

• Main Authors: Chang, L. (Author), Pan, S.-D (Author), Yan, F.-X (Author), Zhang, X. (Author)
• Format: Article
• Language: English
• Published: Frontiers Media S.A. 2022
• Subjects: anesthesiological procedure; Article; blood pressure; bradycardia; child; children; China; common bile duct cyst; continuous infusion; controlled study; dexmedetomidine; double blind procedure; electroencephalogram; female; groups by age; heart rate; Hirschsprung disease; human; hypotension; hypoxemia; laparoscopic surgery; major clinical study; male; nausea and vomiting; night; nonREM sleep; operation duration; pediatric intensive care unit; pediatric patient; percentage of REM sleep; pilot study; polysomnography; postoperative analgesia; post-operative analgesia; prospective study; pull through operation; randomized controlled trial; respiration depression; sleep; sleep pattern; sleep stage; sleep time; stage 2 sleep; sufentanil
• Online Access: View Fulltext in Publisher

 Background: Previous studies have reported that children who were admitted to the ICU experienced a significant decrease in sleep quality compared to home. We investigated the effects of dexmedetomidine as an adjunct to sufentanil on the sleep in children admitted to the ICU on the first night after major surgery. Methods: This is a prospective study From January to February 2022. Clinical trial number: ChiCTR2200055768, http://www.chictr.org.cn. Fifty-four children aged 1–10 years old children undergoing major laparoscopic surgery were recruited and randomly assigned to either the DEX group, in which intravenous dexmedetomidine (0.3 ug/kg/h) and sufentanil (0.04 ug/kg/h) were continuously infused intravenously for post-operative analgesia; or the SUF group, in which only sufentanil (0.04 ug/kg/h) was continuously infused. Patients were monitored with polysomnography (PSG) on the first night after surgery for 12 h. PSG, sleep architecture, physiologic variables and any types of side effects related to anesthesia and analgesia were recorded. The differences between the two groups were assessed using the chi-square and Wilcoxon rank-sum tests. Results: Fifty-four children completed data collection, of which thirty-four were 1–6 years old and twenty were aged >6 years. Compared to the SUF group, subjects in the DEX group aged 1–6 years displayed increased stage 2 sleep duration (P = 0.02) and light sleep duration (P = 0.02). Subjects aged >6 years in the DEX group also displayed increased stage 2 sleep duration (P = 0.035) and light sleep duration (P = 0.018), but decreased REM sleep percentage (P = 0). Additionally, the heart rate and blood pressure results differed between age groups, with the heart rates of subjects aged >6 years in DEX group decreasing at most time points compared to SUF group (P < 0.05). Conclusion: Dexmedetomidine prolonged N2 sleep and light sleep duration in the pediatric ICU after surgery but had different effects on the heart rate and blood pressure of subjects in different age groups. Copyright © 2022 Zhang, Chang, Pan and Yan.