Effects of Dexmedetomidine on Sleep Quality in Critically Ill Patients

Alexopoulou, Christina; Kondili, Eumorfia; Diamantaki, Eleni; Psarologakis, Charalambos; Kokkini, Sofia; Bolaki, Maria; Georgopoulos, Dimitris

doi:10.1097/aln.0000000000000361

Cited by 148 publications

(96 citation statements)

References 30 publications

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“…excessive sputum production and incessant coughing) usually result in poor sleep [2]. Dexmedetomidine is widely used in the mechanically ventilated patients in ICU for sedation and better sleep quality [6]. In our study, we found that the patients with dexmedetomide had less sleep disturbance.…”

Section: Discussionsupporting

confidence: 47%

Dexmedetomidine in combination with sufentanil for postoperative analgesia after partial laryngectomy

et al. 2017

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BackgroundDexmedetomidine as an adjunct with opioids has been confirmed to spare opioids usage and improve analgesia for postoperative pain treatment. Furthermore, dexmedetomidine can attenuate the airway reflex. The aim of this study is to assess the safety and efficacy of dexmedetomidine combined with sufentanil for postoperative analgesia after partial laryngectomy.MethodsA total of 60 adult male patients were recruited and randomly allocated to receive sufentanil 1.0 μg ml−1 (Group S) or sufentanil 1.0 μg ml−1 plus dexmedetomidine 4 μg ml−1 (Group SD) for postoperative analgesia. The IV patient controlled analgesia (PCA) device was programmed to deliver 1.5 ml per demand with a 10 min lockout interval and 1.5 ml per hour background infusion. Cumulative consumption of sufentanil and pain intensity during 24 hour (h) after surgery were recorded. Coughing episodes per day, sleep quality, hemodynamic and respiratory profiles were measured.ResultsCompared with Group S, patients in Group SD required less sufentanil during the 0–24 h postoperative period (p < 0.0001) and reported significant lower pain intensity from the second postoperative hour to the end of the study (P < 0.0001). Daily coughing episodes, sleep disturbance was lower and patients’ satisfaction was higher in Group SD (P < 0.05). Decrease in heart rate and mean blood pressure from baseline at 1 h, 2 h, 3 h, 12 h, and 24 h after operation were significantly greater in Group SD (P = 0.00). The incidence of PCA related adverse events were comparable between the two groups.ConclusionDexmedetomidine/sufentanil combination for postoperatjve analgesia in partial laryngectomized patients resulted in significant sufentanil sparing, better analgesia, reduced frequency coughing episodes, and better sleep quality.Trial registrationChinese Clinical Registry (ChiCTR): ChiCTR-TRC-14004618, date of registration: 08 May 2014.

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Section: Discussionsupporting

confidence: 47%

Dexmedetomidine in combination with sufentanil for postoperative analgesia after partial laryngectomy

et al. 2017

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“…This is a central neural pathway playing a key role in inducing natural sleep. Dexmedetomidine has been shown to have the ability to improve natural sleep when given to intensive care patients in both low, non-sedative dosages [18] and in sedative dosages [19]. Dexmedetomidine also lowers sympathetic tone.…”

Section: Discussionmentioning

confidence: 99%

Dexmedetomidine versus Midazolam in Procedural Sedation. A Systematic Review of Efficacy and Safety

et al. 2017

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ObjectivesTo systematically review the literature comparing the efficacy and safety of dexmedetomidine and midazolam when used for procedural sedation.Materials and MethodsWe searched MEDLINE, EMBASE and COCHRANE for clinical trials comparing dexmedetomidine and midazolam for procedural sedation up to June 20, 2016. Inclusion criteria: clinical trial, human subjects, adult subjects (≥18 years), article written in English, German, French or Dutch, use of study medication for conscious sedation and at least one group receiving dexmedetomidine and one group receiving midazolam. Exclusion criteria: patients in intensive care, pediatric subjects and per protocol use of additional sedative medication other than rescue medication. Outcome measures for efficacy comparison were patient and clinician satisfaction scores and pain scores; outcome measures for safety comparison were hypotension, hypoxia, and circulatory and respiratory complications.ResultsWe identified 89 papers, of which 12 satisfied the inclusion and exclusion criteria; 883 patients were included in these studies. Dexmedetomidine was associated with higher patient and operator satisfaction than midazolam. Patients receiving dexmedetomidine experienced less pain and had lower analgesic requirements. Respiratory and hemodynamic safety were similar.ConclusionsDexmedetomidine is a promising alternative to midazolam for use in procedural sedation. Dexmedetomidine provides more comfort during the procedure for the patient and clinician. If carefully titrated, the safety profiles are similar.

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“…In a similar study of 13 hemodynamically stable ICU patients not requiring vasoactive or sedative medications, patients were monitored with polysomnography for 3 nights, receiving dexmedetomidine on the second night only and no sedatives the other 2 nights to serve as a control. 77 They found dexmedetomidine improved sleep efficiency (P<0.002) and stage 2 sleep (P=0.006) while decreasing night-time sleep fragmentation (P=0.023). This limited data in critically ill patients is consistent with additional data indicating that sedation with dexmedetomidine more closely resembles natural non-REM sleep than sedation with γ-aminobutyric acid (GABA)ergic agents.…”

Section: Delirium Preventionmentioning

confidence: 94%

Intensive Care Unit Delirium

2016

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Effects of Dexmedetomidine on Sleep Quality in Critically Ill Patients

Abstract: In highly selected critically ill patients, dexmedetomidine infusion during the night to achieve light sedation improves sleep by increasing sleep efficiency and stage 2 and modifies the 24-h sleep pattern by shifting sleep mainly to the night.

Cited by 148 publications

References 30 publications

Dexmedetomidine in combination with sufentanil for postoperative analgesia after partial laryngectomy

Dexmedetomidine in combination with sufentanil for postoperative analgesia after partial laryngectomy

Dexmedetomidine versus Midazolam in Procedural Sedation. A Systematic Review of Efficacy and Safety

Intensive Care Unit Delirium

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