Effects of intraoperative sodium oxybate infusion on post-operative sleep quality in patients undergoing gynecological laparoscopic surgery: A randomized clinical trial

• Published in: Journal of clinical anesthesia 2024-05, Vol.93, p.111349-111349, Article 111349
• Main Authors: Cui, Meiying, Xing, Tianyi, Zhao, Anqi, Zheng, Lanlan, Zhang, Xinping, Xue, Hang, Wu, Ziyi, Wang, Fang, Zhao, Ping
• Format: Article
• Language: English
• Subjects: Adult; Anesthesia; Circadian rhythm; Clinical outcomes; Clinical trials; Double-Blind Method; FDA approval; Female; General anesthesia; Gynecological laparoscopic surgery; Gynecology; Humans; Laparoscopy; Laparoscopy - adverse effects; Melatonin; Pain; Pain, Postoperative - drug therapy; Pain, Postoperative - etiology; Pain, Postoperative - prevention & control; Patients; Post-operative sleep quality; Postoperative period; Prospective Studies; Questionnaires; Richards–Campbell sleep questionnaire; Sleep; Sleep deprivation; Sleep Quality; Sodium; Sodium oxybate; Sodium Oxybate - therapeutic use; Surgery; Treatment Outcome
• ISSN: 0952-8180; 1873-4529
• DOI: 10.1016/j.jclinane.2023.111349

Post-operative sleep quality is an important factor that influences post-operative recovery. Sodium oxybate has been used to treat sleep disturbances associated with various pathological conditions. However, whether intraoperative intravenous infusion of sodium oxybate improves post-operative sleep quality is unknown. This study aimed to examine the effects of sodium oxybate on the post-operative sleep quality of patients who underwent gynecological laparoscopic surgery. A single-center, prospective, two-arm, double-blinded randomized controlled trial. The Shengjing Hospital of China Medical University in Liaoning, China. We enrolled 180 adult patients (90 for each group) undergoing elective gynecological laparoscopic surgery, and 178 patients (89 for each group) were included in the final analysis. Patients were randomly allocated in a 1:1 ratio to receive either sodium oxybate (30 mg kg−1) or an equivalent volume of saline after intubation. The patients, anesthetists, and follow-up staff were blinded to group assignment. The primary outcome was sleep quality measured using the Richards–Campbell Sleep Questionnaire (RCSQ) on post-operative days (PODs) one and three. Secondary outcomes included post-operative pain measured using the visual analog scale, sleep quality at one and three months post-operatively measured using the Pittsburgh Sleep Quality Index, and factors associated with post-operative sleep quality. Analysis with generalized estimating equations showed that sodium oxybate significantly improved post-operative sleep quality, as represented by increased total RCSQ scores (mean difference (95% CI); 9 (2, 16), P = 0.010) over PODs one and three. There was no difference in post-operative pain between the two groups over PODs one and three or in post-operative sleep quality over one and three months post-operatively. Age, surgery type, start time of surgery, and use of sufentanil-based patient-controlled intravenous analgesia were significantly associated with post-operative sleep quality. Intraoperative sodium oxybate infusion improved post-operative sleep in patients who underwent gynecological laparoscopic surgery. Trial registration. Chinese Clinical Trial Registry, Clinical trial number: ChiCTR2200061460. •Post-operative sleep disturbance is commonly seen in surgical population.•Richards-Campbell Sleep Questionnaire scores are validated tools for assessing postoperative sleep quality.•Sodium oxybate improves post-operative sleep quality by re