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The Impact of Quality of Sleep on Recovery from Fast-Track Abdominal Hysterectomy
Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
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2012 (English)In: Journal of Clinical Sleep Medicine (JCSM), ISSN 1550-9389, E-ISSN 1550-9397, Vol. 8, no 4, 395-402 p.Article in journal (Refereed) Published
Abstract [en]

Study Objectives: To examine the impact of mode of anesthesia on perceived quality of sleep and to analyze the perceived quality of sleep in affecting recovery from surgery. less thanbrgreater than less thanbrgreater thanMethods: A randomized, controlled, open multicenter trial was conducted in 5 hospitals in Southeast Sweden. One-hundred eighty women scheduled for fast-track abdominal hysterectomy for benign conditions were randomized to spinal anesthesia or general anesthesia; 162 women completed the trial; 82 allocated to spinal anesthesia and 80 to general anesthesia. Symptoms and perceived quality of sleep after surgery were registered daily in the Swedish Postoperative Symptoms Questionnaire. less thanbrgreater than less thanbrgreater thanResults: Women in the general anesthesia group experienced bad quality of sleep the night after surgery significantly more often than the women who had spinal anesthesia (odds ratio [OR] 2.45; p = 0.03). This was almost exclusively attributed to a significantly higher consumption of opioids postoperatively in the general anesthesia group. Risk factors for bad quality of sleep during the first night postoperatively were: opioids (OR 1.07; p = 0.03); rescue antiemetics (OR 2.45; p = 0.05); relative weight gain (OR 1.47; p = 0.04); summary score of postoperative symptoms (OR 1.13; p = 0.02); and stress coping capacity (OR 0.98; p = 0.01). A longer hospital stay was strongly associated with a poorer quality of sleep the first night postoperatively (p = 0.002). less thanbrgreater than less thanbrgreater thanConclusions: The quality of sleep the first night after abdominal hysterectomy is an important factor for recovery. In fast-track abdominal hysterectomy, it seems important to use anesthesia and multimodal analgesia reducing the need for opioids postoperatively and to use strategies that diminish other factors that may interfere negatively with sleep. Efforts to enhance quality of sleep postoperatively by means of preventive measures and treatment of sleep disturbances should be included in fast-track programs.

Place, publisher, year, edition, pages
American Academy of Sleep Medicine , 2012. Vol. 8, no 4, 395-402 p.
Keyword [en]
Abdominal hysterectomy, fast track, general anesthesia, quality of sleep, postoperative recovery, spinal anesthesia
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-85614DOI: 10.5664/jcsm.2032ISI: 000310059400009OAI: oai:DiVA.org:liu-85614DiVA: diva2:571887
Note

Funding Agencies|Medical Research Council of South East Sweden||Linkoping University||County Council of Ostergotland||

Available from: 2012-11-26 Created: 2012-11-26 Last updated: 2017-12-07

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Kjölhede, PrebenBorendal Wodlin, NinnieNilsson, Lena

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Obstetrics and gynecologyFaculty of Health SciencesDepartment of Gynaecology and Obstetrics in LinköpingDepartment of Clinical and Experimental MedicineAnesthesiologyDepartment of Anaesthesiology and Intensive Care in Linköping
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Journal of Clinical Sleep Medicine (JCSM)
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