• Anesthesia and analgesia · Apr 2013

    Occurrence of rapid eye movement sleep deprivation after surgery under regional anesthesia.

    • Frank Dette, Werner Cassel, Friederike Urban, Martin Zoremba, Ulrich Koehler, Hinnerk Wulf, Jürgen Graf, and Thorsten Steinfeldt.
    • Department of Anesthesiology, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131 Mainz, Germany. Frank.Dette@web.d
    • Anesth. Analg.. 2013 Apr 1;116(4):939-43.

    BackgroundSleep disturbances after general surgery have been described. In this study, we assessed rapid eye movement (REM) sleep in patients undergoing knee replacement surgery using a regional anesthetic technique.MethodsAmbulatory polysomnography (PSG) was performed on 3 nights: the night before surgery (PSG1), the first night after surgery (PSG2), and the fifth postoperative night (PSG3). Postoperative analgesia was maintained with peripheral nerve catheters for the first 3 days and with oral opioids thereafter. In addition, nonsteroidal antiinflammatory drugs were administered. Postoperative pain was monitored using a visual analog scale.ResultsPSG was performed in 12 patients, 6 men and 6 women, with a mean age of 61 (±12) years. REM sleep was reduced from PSG1 (median 16.4%) to PSG2 (median 6.3%; P = 0.02). The Hodges-Lehmann estimate for the median reduction is -7.8% (95% confidence interval -14.8% to -0.7%). During PSG3, significantly more REM sleep was detected (median 15.4%) compared with PSG2 (P = 0.01). The Hodges-Lehmann estimate for this median increase is 10.0% (95% confidence interval 1.7%-25.3%).ConclusionPostoperative reduction of REM sleep also occurs after surgery and regional anesthesia.

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