Effect of improving sleep quality the night before surgery with zolpidem on postoperative gastrointestinal function in patients undergoing laparoscopic partial colorectal resection: a randomized, double-blind, controlled trial.

Abstract

Background: Sleep is one of the basic physiological needs of human beings. Preoperative sleep disorders are associated with poor prognosis in surgical patients, and sleep disorders have been shown to be one of the risk factors for gastrointestinal dysfunction. However, there are now few studies to investigate whether improving preoperative sleep disorders can promote the recovery of postoperative gastrointestinal function. This study aimed to investigate the effects and significance of improving preoperative sleep quality with zolpidem on postoperative gastrointestinal function.

Methods: In this prospective, randomized, double-blind clinical trial, 76 patients undergoing elective laparoscopic partial colorectal resection and with a Pittsburgh Sleep Quality Index (PSQI) score > 5, were randomly divided into two groups. The zolpidem group (Group Z, n = 38) was given a capsule containing 10 mg of zolpidem the night before the operation, and the control group (Group C, n = 38) was given an empty capsule the night before the operation. Follow-up visits were performed on the 1st, 3rd, and 7th postoperative days, respectively. The primary outcome of this study was the I-FEED (Intake, Feeling nauseated, Emesis, Physical Exam, and Duration of symptoms) score on the third postoperative day (POD3). Secondary outcomes included time to postoperative first flatus, first feces, and first food intake (semi-liquid diet), I-FEED scores, visual analog scores (VAS) during coughing and at rest, times of patient-controlled intravenous analgesia (PCIA) effective presses, sufentanil dosage, number of remedial analgesia in the 24-hour postoperative period, and changes in inflammatory markers (TNF-α).

Results: Compared with Group C, Group Z had a lower I-FEED score on POD1 (P < 0.05) and shorter time to first flatus and first food intake (P < 0.05); there were significant differences between the two groups in VAS scores during coughing and at rest on POD1, VAS score during coughing on POD3, times of PCIA effective presses and sufentanil dosage in the 24-hour postoperative period, and patient satisfaction (P < 0.05).

Conclusion: For patients with sleep disorders, the use of zolpidem to improve sleep the night before surgery is beneficial in partially improving postoperative gastrointestinal function, relieving postoperative pain, and increasing patient satisfaction.

Test registration: ChiCTR2300077566 November 13, 2023.