title: Occurrence of rapid eye movement sleep deprivation after surgery under regional anesthesia.
abstract: BACKGROUND
  Sleep disturbances after general surgery have been described. In this study, we assessed rapid eye movement (REM) sleep in patients undergoing knee replacement surgery using a regional anesthetic technique.
  
  
  METHODS
  Ambulatory polysomnography (PSG) was performed on 3 nights: the night before surgery (PSG1), the first night after surgery (PSG2), and the fifth postoperative night (PSG3). Postoperative analgesia was maintained with peripheral nerve catheters for the first 3 days and with oral opioids thereafter. In addition, nonsteroidal antiinflammatory drugs were administered. Postoperative pain was monitored using a visual analog scale.
  
  
  RESULTS
  PSG was performed in 12 patients, 6 men and 6 women, with a mean age of 61 (±12) years. REM sleep was reduced from PSG1 (median 16.4%) to PSG2 (median 6.3%; P = 0.02). The Hodges-Lehmann estimate for the median reduction is -7.8% (95% confidence interval -14.8% to -0.7%). During PSG3, significantly more REM sleep was detected (median 15.4%) compared with PSG2 (P = 0.01). The Hodges-Lehmann estimate for this median increase is 10.0% (95% confidence interval 1.7%-25.3%).
  
  
  CONCLUSIONS
  Postoperative reduction of REM sleep also occurs after surgery and regional anesthesia.
authors: Department of Anesthesiology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131 Mainz, Germany. Frank.Dette@web.d
authors: Frank
authors: F
authors: Dette
authors: Werner
authors: W
authors: Cassel
authors: Friederike
authors: F
authors: Urban
authors: Martin
authors: M
authors: Zoremba
authors: Ulrich
authors: U
authors: Koehler
authors: Hinnerk
authors: H
authors: Wulf
authors: Jürgen
authors: J
authors: Graf
authors: Thorsten
authors: T
authors: Steinfeldt
mesh_terms: D000368:Aged; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000765:Anesthesia, Conduction / Q000009:adverse effects*; D000779:Anesthetics, Local; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D019645:Arthroplasty, Replacement, Knee; D002045:Bupivacaine; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D010147:Pain Measurement; D010149:Postoperative Pain / Q000453:epidemiology / Q000628:therapy; D010865:Pilot Projects; D017286:Polysomnography; D011183:Postoperative Complications / Q000453:epidemiology*; D012892:Sleep Deprivation / Q000453:epidemiology* / Q000209:etiology*
chemical_list: D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D000894:Anti-Inflammatory Agents, Non-Steroidal; D010100:Oxygen; D002045:Bupivacaine