术前睡眠障碍与急性术后疼痛控制之间的关系:系统回顾与荟萃分析

IF 11.2 1区 医学 Q1 CLINICAL NEUROLOGY Sleep Medicine Reviews Pub Date : 2024-10-05 DOI:10.1016/j.smrv.2024.102014
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引用次数: 0

摘要

术前睡眠质量差和睡眠连续性受损可能会加重术后急性疼痛的强度并增加镇痛剂的消耗,从而对术后恢复、精神和身体健康产生负面影响。本综述的主要目的是研究术前睡眠障碍与急性术后疼痛控制之间的关系。从开始到 2023 年 12 月,对四个电子数据库进行了系统检索。两位审稿人筛选了文章、提取了数据,并评估了每项纳入研究的偏倚风险。此次检索共发现 26 项前瞻性队列研究和 3 项回顾性队列研究(16104 名参与者)。在纳入的 29 项研究中,23 项研究关注术前失眠症状,3 项研究分别关注术前客观睡眠连续性或睡眠呼吸障碍。基于 5 项研究、1226 名参与者的 Meta 分析表明,具有临床意义的术前失眠症状与术后第一天的中度至重度疼痛强度有关(几率比 2.69(95 % 置信区间 2.03-3.57),p < 0.0001)。定性分析显示,术前失眠症状、睡眠连续性受损与急性和亚急性术后疼痛控制较差之间存在相对密切的联系。与阻塞性睡眠呼吸暂停综合征有关的研究结果不一。鉴于失眠是一个潜在的可改变的风险因素,针对术前睡眠的干预措施可能会改善术后疼痛控制。
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The relationship between preoperative sleep disturbance and acute postoperative pain control: A systematic review and meta-analysis
Poor preoperative sleep quality and impaired sleep continuity may heighten acute postoperative pain intensity and increase analgesic consumption, with negative implications for recovery, mental and physical health. The main objective of the current review was to investigate the relationship between preoperative sleep disturbance and acute postoperative pain control. Four electronic databases were systematically searched from inception to December 2023. Two reviewers screened articles, extracted data, and assessed risk of bias for each included study. The search identified 26 prospective cohort studies and 3 retrospective cohort studies (16104 participants). Of the 29 included studies, 23 focused on preoperative insomnia symptoms, and three studies each focused on preoperative objective sleep continuity or sleep-disordered breathing. Meta-analysis, based on five studies with 1226 participants, showed that clinically significant preoperative insomnia symptoms were associated with moderate to severe pain intensity on the first postoperative day (odds ratio 2.69 (95 % confidence interval 2.03–3.57), p < 0.0001). Qualitative analysis showed relatively robust associations between preoperative insomnia symptoms, impaired sleep continuity and poorer acute, as well as subacute, postoperative pain control. Findings related to obstructive sleep apnea syndrome were mixed. Given that insomnia is a potentially modifiable risk factor, interventions targeting sleep prior to surgery may improve postoperative pain control.
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来源期刊
Sleep Medicine Reviews
Sleep Medicine Reviews 医学-临床神经学
CiteScore
20.10
自引率
3.80%
发文量
107
期刊介绍: Sleep Medicine Reviews offers global coverage of sleep disorders, exploring their origins, diagnosis, treatment, and implications for related conditions at both individual and public health levels. Articles comprehensively review clinical information from peer-reviewed journals across various disciplines in sleep medicine, encompassing pulmonology, psychiatry, psychology, physiology, otolaryngology, pediatrics, geriatrics, cardiology, dentistry, nursing, neurology, and general medicine. The journal features narrative reviews, systematic reviews, and editorials addressing areas of controversy, debate, and future research within the field.
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