title: Changes in postoperative night bispectral index of patients undergoing thoracic surgery with different types of anaesthesia management: a randomized controlled trial.
abstract: This study hypothesized that different types of anaesthesia management would result in similar postoperative sleep quality. In this prospective single-blind investigation, 219 patients undergoing elective thoracic surgery were randomized into three arms: general anaesthesia, as the control group (group C); general anaesthesia combined with thoracic epidural anaesthesia (TEA) (group E); and general anaesthesia combined with infusion of 1 μg/kg dexmedetomidine (group D). Plasma samples were obtained to measure the amine and inflammatory cytokine concentrations. All patients underwent assessment with the bispectral index (BIS) for sleep quality and the visual analogue scale (VAS) for pain. The primary outcomes were inflammatory cytokine [interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-α)] secretion and postoperative sleep quality on the first and second postoperative nights. The secondary outcomes were amine (adrenaline and noradrenaline) secretion during the surgical period and haemodynamic stability. The postoperative BIS area under the curve was significantly lower in group E (75.7%) than in group C (87.3%) or group D (86.5%). Patients in group E had the highest BIS of sleep efficiency index (29.2%, P < 0.05) and the lowest VAS scores (3.5, P < 0.05). Group E had lower IL-6 levels than the other two groups 24 h after surgery (P < 0.05). Patients given TEA may show reduced sleep disturbances on the first night after surgery, perhaps due to better pain management and inhibition of IL-6 release.
authors.affiliation: Department of Anaesthesiology, the First Hospital of China Medical University, Shenyang, China.
authors.forename: Wen-fei
authors.initials: WF
authors.lastname: Tan
authors.affiliation: Department of Anaesthesiology, the First Hospital of China Medical University, Shenyang, China.
authors.forename: Bing
authors.initials: B
authors.lastname: Guo
authors.affiliation: Department of Anaesthesiology, the First Hospital of China Medical University, Shenyang, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Ma
authors.affiliation: Department of Anaesthesiology, the First Hospital of China Medical University, Shenyang, China.
authors.forename: Xiao-Qian
authors.initials: XQ
authors.lastname: Li
authors.affiliation: Department of Anaesthesiology, the First Hospital of China Medical University, Shenyang, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Fang
authors.affiliation: Department of Anaesthesiology, the First Hospital of China Medical University, Shenyang, China.
authors.forename: Huang-Wei
authors.initials: HW
authors.lastname: Lv
mesh_terms: D000328:Adult; D000368:Aged; D000768:Anesthesia, General / Q000009:adverse effects*; D001794:Blood Pressure / Q000187:drug effects; D056805:Consciousness Monitors; D020927:Dexmedetomidine / Q000494:pharmacology; D004837:Epinephrine / Q000097:blood; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D009638:Norepinephrine / Q000097:blood; D011184:Postoperative Period; D016037:Single-Blind Method; D012890:Sleep / Q000187:drug effects / Q000502:physiology*; D013312:Stress, Physiological / Q000187:drug effects; D019616:Thoracic Surgical Procedures / Q000009:adverse effects*; D014409:Tumor Necrosis Factor-alpha / Q000097:blood / Q000378:metabolism
chemical_list: D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D020927:Dexmedetomidine; D009638:Norepinephrine; D004837:Epinephrine
keywords: bispectral index; inflammatory cytokine; sleep