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Meta-Analysis
. 2024 Dec 5;19(12):e0314814.
doi: 10.1371/journal.pone.0314814. eCollection 2024.

Effect of perioperative dexmedetomidine on sleep quality in adult patients after noncardiac surgery: A systematic review and meta-analysis of randomized trials

Lin Wang  1   2   3 , Xin-Quan Liang  1 , Yan-Xia Sun  2   3 , Zhen Hua  2   3 , Dong-Xin Wang  1   4
Affiliations
Meta-Analysis

Effect of perioperative dexmedetomidine on sleep quality in adult patients after noncardiac surgery: A systematic review and meta-analysis of randomized trials

Lin Wang et al. PLoS One. .

Abstract

Background: Dexmedetomidine may improve sleep quality after surgery, but conflicting results also exist. Herein, we explored the effects of perioperative dexmedetomidine on postoperative sleep quality in adult patients.

Methods: In this systematic review and meta-analysis, randomized controlled trials investigating the effects of perioperative dexmedetomidine on sleep quality after noncardiac surgery were retrieved from Cochrane Library, PubMed, and EMBASE from inception to January 12, 2023, and updated on March 15, 2024. The Cochrane Collaboration's tool was applied to assess risk of bias. A random-effects model was used for meta-analysis. The primary outcome was the subjective sleep quality score on the first night after surgery.

Results: A total of 29 trials containing 5610 participants were included. The subjective sleep score on the first postoperative night was lower (better) with dexmedetomidine than with placebo (SMD [standardized mean difference] = -0.8, 95% CI -1.1 to -0.6, p<0.00001; I2 = 93%; 22 trials; n = 4611). Sensitivity analysis showed that overall conclusion was not changed (SMD = -0.8, 95% CI -1.1 to -0.5, p<0.00001; I2 = 93%; 14 trials; n = 3846). Results of polysomnographic monitoring showed improved sleep structure with dexmedetomidine on the first night after surgery, as manifested by increased sleep efficiency index and stage N2 sleep and decreased arousal index and stage N1 sleep.

Conclusions: This systematic review suggests that, among patients who underwent noncardiac surgery, perioperative dexmedetomidine administration may improve early postoperative sleep quality pattern. However, the resulting evidence were of low or very low qualities and further studies are required to confirm our results.

Prospero registration number: CRD42023390972.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Literature search and study selection process according to the PRISMA guidelines.
Fig 2
Fig 2. Risk of bias of the included studies.
Fig 3
Fig 3. Forest plot of the pooled analysis showing subjective sleep score on the first night after surgery.
Subgroup analyses were performed according to age (A) and timing of dexmedetomidine administration (B).
See this image and copyright information in PMC

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