title: Changes in First Postoperative Night Bispectral Index After Daytime Sedation Induced by Dexmedetomidine or Midazolam Under Regional Anesthesia: A Randomized Controlled Trial.
abstract: OBJECTIVE
  Supplementation of spinal anesthesia with various sedatives is a standard protocol to alleviate patient anxiety associated with the surgical procedure. We hypothesized that, compared with dexmedetomidine, midazolam might have a subtle influence on sleep quality after surgery following elective transurethral prostatic resection (TURP) in elderly male patients.
  
  
  METHODS
  A randomized, double-blind, controlled trial was conducted at the First Hospital of China Medical University from July 2014 to January 2015. One hundred eleven patients undergoing TURP were enrolled and received intravenous saline infusion (control group), dexmedetomidine (dexmedetomidine group), or midazolam (midazolam group) for sedation during the spinal anesthesia procedure. The intraoperative sedative state and postoperative sleep quality were evaluated using a Bispectral Index (BIS)-Vista monitor. The primary outcome was postoperative sleep quality, as measured by the BIS-Vista monitor on the first night after surgery.
  
  
  RESULTS
  The intraoperative BIS area under the curve value was significantly lower in the dexmedetomidine group (54.1%) compared with those in the other 2 groups (control group, 94.1%; midazolam group, 77.2%).The postoperative BIS area under the curve value was highest in the dexmedetomidine group at 88.7%. The BIS sleep efficiency index showed a significant 33.1% increase in the midazolam group compared with the dexmedetomidine group. The duration of sleep in the midazolam group was 237.8 minutes longer than that in the dexmedetomidine group.
  
  
  CONCLUSIONS
  We conclude that midazolam combined with spinal anesthesia might preserve the sleep quality of elderly male patients immediately after TURP.
authors.affiliation: From the Department of Anesthesiology, The First Hospital of China Medical University, Shenyang, China.
authors.forename: Wen-fei
authors.initials: WF
authors.lastname: Tan
authors.forename: Er-ya
authors.initials: EY
authors.lastname: Miao
authors.forename: Feng
authors.initials: F
authors.lastname: Jin
authors.forename: Hong
authors.initials: H
authors.lastname: Ma
authors.forename: Huang-wei
authors.initials: HW
authors.lastname: Lu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000775:Anesthesia, Spinal / Q000009:adverse effects / Q000379:methods*; D002681:China; D003243:Consciousness / Q000187:drug effects*; D056805:Consciousness Monitors; D020927:Dexmedetomidine / Q000008:administration & dosage* / Q000009:adverse effects; D004311:Double-Blind Method; D017558:Elective Surgical Procedures; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage* / Q000009:adverse effects; D007262:Infusions, Intravenous; D008297:Male; D008874:Midazolam / Q000008:administration & dosage* / Q000009:adverse effects; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000295:instrumentation*; D011182:Postoperative Care; D011237:Predictive Value of Tests; D012890:Sleep / Q000187:drug effects*; D013997:Time Factors; D020728:Transurethral Resection of Prostate
chemical_list: D006993:Hypnotics and Sedatives; D020927:Dexmedetomidine; D008874:Midazolam