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Dexmedetomidine-soaked nasal packing can reduce pain and improve sleep quality after nasal endoscopic surgery: a double-blind, randomized, controlled clinical trial

  • Sleep Breathing Physiology and Disorders • Original Article
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Abstract

Study objective

Bilateral endoscopic nasal surgery is usually associated with pain and sleep disturbance. The aim of this study was to evaluate the effects of dexmedetomidine-soaked nasal packing on analgesia and improvement of sleep quality in patients undergoing this surgery.

Method

Eighty patients were enrolled and randomly allocated into 4 groups. At the end of surgery, dexmedetomidine-soaked nasal packings were applied to three groups with a dosage of 1 μg kg−1 (D1), 2μg kg−1 (D2), 4 μg kg−1 (D4) and normal saline-soaked nasal packing (NS) was applied to a fourth group. The primary outcome was postoperative pain scores using a visual analog scale (VAS) recorded at six time points: before the surgery (T1); 2 h (T2), 8 h (T3), 24 h (T4), 48 h (T5) after surgery; and at the moment of nasal packing removal (T6). Secondary outcomes were postoperative sleep status evaluated by the Pittsburgh sleep quality index (PSQI) and subjective sleep quality value (SSQV). Factors affecting sleep, hemodynamic changes, and adverse events were also recorded.

Results

Compared with the NS group, dexmedetomidine-soaked nasal packing significantly relieved postoperative pain and improved sleep quality. The effect was similar between D2 and D4, which was greater than in D1. However, D2 was associated with fewer adverse events.

Conclusions

Dexmedetomidine-soaked nasal packing not only offers effective analgesia but also improves postoperative sleep quality in patients undergoing bilateral endoscopic nasal surgery. Taking effect and adverse events into consideration, a dosage of 2μg kg−1 may be optimal.

Trial registration

www.chictr.org.cn/index.aspx (ChiCTR1900025692) Retrospectively registered 5 September 2019

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Acknowledgements

The authors thank the nurses and doctors of the surgery and anesthesiology departments of the First Affiliated Hospital of Shantou University Medical College, especially Qingyu Xiao, who helped in the execution of the study.

Funding

This work was supported by the Shantou City Science and Technology Plan Project, Guangdong Province, China (Grant Number: 2016-11).

Author information

Author notes

  1. Yuting Wang and Yu Shuai contributed equally to this work.

Authors and Affiliations

  1. Department of Anesthesiology, The Seventh Affiliated Hospital of Sun Yat-sen University, Shen Zhen, China

    Yuting Wang

  2. Department of Anesthesiology, The First Affiliated Hospital of Shantou University Medical College, 57 Changping Road, Shan Tou, 515000, China

    Yu Shuai, Jiamei He & Shaohui Zhuang

  3. Department of ENT, The First Affiliated Hospital of Shantou University Medical College, Shan Tou, China

    Fudan Qiu

Authors
  1. Yuting Wang
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  2. Yu Shuai
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  4. Jiamei He
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  5. Shaohui Zhuang
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Contributions

Yu Shuai and Yuting Wang participated in the design of the study, coordinated the study, performed the database validation, statistical analyses, and wrote the manuscript. Fudan Qiu coordinated the patient recruitment, assessments, and follow-up; collected the data; and performed the data entry. Jiamei He participated in the design of the study, enrolled the patients, and administered the anesthesia. Shaohui Zhuang participated in the design of the study and in writing the manuscript.

Corresponding author

Correspondence to Shaohui Zhuang.

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Wang, Y., Shuai, Y., Qiu, F. et al. Dexmedetomidine-soaked nasal packing can reduce pain and improve sleep quality after nasal endoscopic surgery: a double-blind, randomized, controlled clinical trial. Sleep Breath 25, 2045–2052 (2021). https://doi.org/10.1007/s11325-021-02342-y

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  • DOI: https://doi.org/10.1007/s11325-021-02342-y

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