Impact of different perioperative dexmedetomidine administration regimens on postoperative sleep quality in gastrointestinal tumor resection: a randomized controlled trial.

Introduction: Perioperative sleep disorders constitute a recognized risk factor for multiple postoperative complications. Although dexmedetomidine (DEX) has been clinically employed to enhance perioperative sleep quality, its optimal administration protocol for postoperative sleep improvement remains undetermined.

Aim: The aim of this study was to comparatively evaluate the therapeutic effect of distinct perioperative DEX administration strategies on postoperative sleep quality in patients undergoing elective gastrointestinal tumor resection via laparoscopy.

Materials and methods: A total of 48 patients undergoing laparoscopic gastrointestinal resection between September 2024 and January 2025 were enrolled and randomly allocated to the intraoperative continuous DEX infusion group (group I; n = 24) and the group with DEX added to postoperative intravenous analgesia (group P; n = 24) using a double-blind method. Sleep quality was assessed using the Numerical Rating Scale during the first 3 postoperative days. A comparative analysis of intergroup differences in postoperative sleep quality was performed.

Results: Out of the 48 randomized participants, 47 were included in the analysis, as 1 patient from group P withdrew informed consent postoperatively. Baseline data were balanced between the 2 groups. In comparison with group I, on postoperative day 1, group P exhibited considerably higher sleep quality scores (P = 0.045), lower blood glucose levels at skin suture completion (P <⁠0.001), higher intraoperative norepinephrine doses (P <⁠0.001), and reduced intraoperative blood loss (P = 0.03). Multivariable linear regression identified group assignment (P = 0.03) and sex (P = 0.02) as significant predictors of sleep quality on postoperative day 1.

Conclusions: As compared with intraoperative continuous DEX infusion, addition of DEX to postoperative analgesia in laparoscopic gastrointestinal tumor surgery has better outcomes with regard to sleep quality on postoperative day 1. These findings suggest potential advantages of postoperative DEX administration in perioperative management.