Effect of Intraoperative Intravenous Infusion of Esketamine Combined with Dexmedetomidine on Postoperative Sleep Disturbance in Patients Undergoing Radical Mastectomy

作者：Xingyu Geng, Yutian Pu, Ziwei Hu, Heling Zhang, Maosan Wang, Can Fang, Gao‐Chao Lv, Wanting Li, Xinyue Zhang, Xiaoxuan Fan, Su Liu, Xiuxia Chen, Jingru Wu · 发表于：Drug Design Development and Therapy · 年份：2025 · DOI：10.2147/dddt.s510222 · 被引用次数：7 · 研究领域：Sleep and Wakefulness Research、Sleep and related disorders、Obstructive Sleep Apnea Research

Objective: 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...