# Intraoperative dexmedetomidine on postoperative sleep disturbance in older patients undergoing major abdominal surgery: A randomized controlled trial protocol

## TL;DR

This study tests if using dexmedetomidine during surgery can reduce sleep problems in older patients after major abdominal surgery.

## Contribution

The study introduces a randomized controlled trial protocol to evaluate two doses of intraoperative dexmedetomidine for reducing postoperative sleep disturbance in elderly patients.

## Key findings

- The trial will assess sleep quality using the Athens Insomnia Scale and wearable devices like Xiaomi Mi Band 7.
- Secondary outcomes include pain levels, delirium, depressive symptoms, and recovery quality in elderly surgical patients.
- Results will provide evidence on whether dexmedetomidine improves postoperative sleep and recovery in older adults.

## Abstract

Postoperative sleep disturbance (PSD) occurs frequently in patients who undergo major abdominal surgical procedures. Dexmedetomidine is a promising agent to improve the quality of sleep for surgical patients. We designed this trial to investigate the effects of two different doses of intraoperative dexmedetomidine on the occurrence of PSD in elderly patients who have major abdominal surgery.

In this randomized, double-blind, controlled trial, 210 elderly patients aged ≥65 years will be randomized, with an allocation ratio of 1:1:1, to two dexmedetomidine groups (intraoperative infusion of 0.3 or 0.6 μg/kg/h) and a normal saline placebo group. The primary endpoint is the occurrence of PSD on the first night after surgery, assessed using the Athens Insomnia Scale. The secondary endpoints are (1) the incidence of PSD during the 2nd, 3rd, 5th, 7th, and 30th nights postoperatively; (2) pain at rest and on movement at 24 and 48 h postoperatively, assessed using the Numerical Rating Scale; (3) the incidence of postoperative delirium during 0–7 days postoperatively or until hospital discharge, assessed using the 3-min Confusion Assessment Method; (4) depressive symptoms during 0–7 days postoperatively or until hospital discharge, assessed using the 15-items Geriatric Depression Scale; and (5) quality of recovery on postoperative days 1, 2, and 3, assessed using the 15-items Quality of Recovery Scale. Patients' sleep data will also be collected by Xiaomi Mi Band 7 for further analysis.

The findings of this trial will provide clinical evidence for improving the quality of sleep among elderly patients undergoing major abdominal surgery.

This trial was approved by the Ethics Committee of the First Affiliated Hospital of Soochow University (No. 2023-160). The results will be published in a peer-reviewed journal.

Chinese Clinical Trial Registry (ChiCTR2300073163).