Dexmedetomidine-soaked nasal packing can reduce pain and improve sleep quality after nasal endoscopic surgery: a double-blind, randomized, controlled clinical trial.

Abstract

STUDY OBJECTIVE:

Bilateral endoscopic nasal surgery is usually associated with pain and sleep disturbance. The aim of this study was to evaluate the effects of dexmedetomidine-soaked nasal packing on analgesia and improvement of sleep quality in patients undergoing this surgery.

METHOD:

Eighty patients were enrolled and randomly allocated into 4 groups. At the end of surgery, dexmedetomidine-soaked nasal packings were applied to three groups with a dosage of 1 μg kg-1 (D1), 2μg kg-1 (D2), 4 μg kg-1 (D4) and normal saline-soaked nasal packing (NS) was applied to a fourth group. The primary outcome was postoperative pain scores using a visual analog scale (VAS) recorded at six time points: before the surgery (T1); 2 h (T2), 8 h (T3), 24 h (T4), 48 h (T5) after surgery; and at the moment of nasal packing removal (T6). Secondary outcomes were postoperative sleep status evaluated by the Pittsburgh sleep quality index (PSQI) and subjective sleep quality value (SSQV). Factors affecting sleep, hemodynamic changes, and adverse events were also recorded.

RESULTS:

Compared with the NS group, dexmedetomidine-soaked nasal packing significantly relieved postoperative pain and improved sleep quality. The effect was similar between D2 and D4, which was greater than in D1. However, D2 was associated with fewer adverse events.

CONCLUSIONS:

Dexmedetomidine-soaked nasal packing not only offers effective analgesia but also improves postoperative sleep quality in patients undergoing bilateral endoscopic nasal surgery. Taking effect and adverse events into consideration, a dosage of 2μg kg-1 may be optimal.

TRIAL REGISTRATION:

www.chictr.org.cn/index.aspx (ChiCTR1900025692) Retrospectively registered 5 September 2019.

• Authors: Yuting Wang, Yu Shuai, Fudan Qiu, Jiamei He, Shaohui Zhuang
• Journal: Sleep & breathing = Schlaf & Atmung (Sleep Breath) Vol. 25 Issue 4 Pg. 2045-2052 (12 2021) ISSN: 1522-1709 [Electronic] Germany
• PMID: 33709192 (Publication Type: Journal Article, Randomized Controlled Trial)
• Copyright: © 2021. The Author(s), under exclusive licence to Springer Nature Switzerland AG.

Chemical References

• Analgesics, Non-Narcotic
• Dexmedetomidine

Topics

• Administration, Topical
• Adult
• Analgesics, Non-Narcotic (administration & dosage, pharmacology)
• Dexmedetomidine (administration & dosage, pharmacology)
• Double-Blind Method
• Female
• Humans
• Male
• Middle Aged
• Nasal Surgical Procedures (adverse effects)
• Natural Orifice Endoscopic Surgery (adverse effects)
• Outcome Assessment, Health Care
• Pain Measurement
• Pain, Postoperative (diagnosis, drug therapy, etiology)
• Sleep Quality