[Comparison of effects of two anesthesia methods on the first night sleep quality in middle-aged and elderly patients undergoing surgery for lower extremity varicose vein].

ABSTRACT

Objective: To investigate effects of two anesthesia methods on the first night sleep quality in middle-aged and elderly patients after surgery. Methods: This was a prospective study conducted from November 2017 to March 2018. Sixty patients, aged 50-70, undergoing elective surgery for unilateral lower extremity varicose vein at Ningbo No.2 Hospital, with American Society of Anesthesiologists (ASA) grade Ⅰ or Ⅱ, were enrolled and randomly allocated to two groups (n=30), general anesthesia group and spinal anesthesia group. On the first day before surgery, the patient's general data were collected and the Pittsburgh sleep quality index (PSQI) was used to assess the patient's sleep status in the past month. The postoperative mean arterial pressure (MAP), heart rate (HR) and pulse oxygen saturation (SpO(2)) in the ward were recorded with a multi-function monitor on first night after surgery. The total sleep time and arousal time were obtained by bispectral index (BIS) monitoring from 20 00 (the first day) to 6 00 (the second day). Athens Insomnia Scale (AIS) was recorded at 18 00 at the second day after surgery. Results: There was no significant difference in general data and PSQI scale scores between the two groups of patients (all P>0.05). And there were no significant differences in MAP, HR, SpO(2) and BIS every 2 hours between the two groups from 20 00 (the first day) to 6 00 (the second day)(all P>0.05). Compared with the general anesthesia group, the first night of total sleep time in the spinal anesthesia group was significantly shorter[(357.2±83.4)min vs (275.1±64.8)min, t=-9.635, P<0.05], while the rate of wakefulness, total sleep time, overall sleep quality, daytime mood and daytime physical function were significantly higher[(25.9%, 22.2%, 25.9%, 18.5%18.5%) vs (51.7%, 51.7%, 55.2%, 48.3%44.8%), χ(2)=3.901, 5.192, 4.941, 5.523 and 4.437, all P<0.05], and the cases of postoperative urinary retention and lower limb discomfort were significantly higher[(8 and 6) vs (1 and 0), all P<0.05]. Conclusion: Both anesthesia methods can be safely and effectively applied to middle-aged and elderly patients with lower extremity varicose veins surgery, but patients with general anesthesia show fewer adverse reactions on the first night after surgery and have better sleep quality.