Postoperative Sleep Disturbances after Zolpidem Treatment in Fast-Track Hip and Knee Replacement
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Postoperative Sleep Disturbances after Zolpidem Treatment in Fast-Track Hip and Knee Replacement. / Krenk, Lene; Jennum, Poul; Kehlet, Henrik.
I: Journal of Clinical Sleep Medicine, Bind 10, Nr. 3, 15.03.2014, s. 321-326.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Postoperative Sleep Disturbances after Zolpidem Treatment in Fast-Track Hip and Knee Replacement
AU - Krenk, Lene
AU - Jennum, Poul
AU - Kehlet, Henrik
PY - 2014/3/15
Y1 - 2014/3/15
N2 - STUDY OBJECTIVES: Previous studies have demonstrated pronounced reduction of REM sleep on the first nights following major surgery which may influence pain, analgesic use, and recovery. This placebo-controlled, randomized, double-blind study set out to evaluate the effect of zolpidem on sleep architecture in an elderly population undergoing fast-track total hip and knee arthroplasty (THA/TKA) with length of stay < 3 days.METHODS: Twenty patients (≥ 60 years) undergoing THA or TKA in a standardized setup with spinal anesthesia and multimodal opioid-sparing postoperative analgesia were included. Polysomnography measures were performed for 2 nights, 1 night at home prior to surgery and on the first night after surgery, when the patient received placebo or zolpidem 10 mg. Analgesic use, pain levels, and subjective measures of fatigue and sleep quality were recorded. Analysis of sleep data was performed according to the American Academy of Sleep Medicine manual.RESULTS: Objective sleep data did not show a significant difference between groups in any of the sleep stages. However, subjective data on sleep quality and fatigue showed significantly less fatigue and better sleep quality in the zolpidem group (p < 0.05), and reduced objectively recorded number of arousals (p = 0.004). Levels of pain and opioid use were similar in the 2 groups.CONCLUSIONS: Our objective data did not support the primary hypothesis that one night's treatment with zolpidem would significantly improve sleep architecture following major surgery, although there was improved feeling of sleep quality and fatigue associated with fewer postoperative arousals.CITATION: Krenk L; Jennum P; Kehlet H. Postoperative sleep disturbances after zolpidem treatment in fast-track hip and knee replacement.
AB - STUDY OBJECTIVES: Previous studies have demonstrated pronounced reduction of REM sleep on the first nights following major surgery which may influence pain, analgesic use, and recovery. This placebo-controlled, randomized, double-blind study set out to evaluate the effect of zolpidem on sleep architecture in an elderly population undergoing fast-track total hip and knee arthroplasty (THA/TKA) with length of stay < 3 days.METHODS: Twenty patients (≥ 60 years) undergoing THA or TKA in a standardized setup with spinal anesthesia and multimodal opioid-sparing postoperative analgesia were included. Polysomnography measures were performed for 2 nights, 1 night at home prior to surgery and on the first night after surgery, when the patient received placebo or zolpidem 10 mg. Analgesic use, pain levels, and subjective measures of fatigue and sleep quality were recorded. Analysis of sleep data was performed according to the American Academy of Sleep Medicine manual.RESULTS: Objective sleep data did not show a significant difference between groups in any of the sleep stages. However, subjective data on sleep quality and fatigue showed significantly less fatigue and better sleep quality in the zolpidem group (p < 0.05), and reduced objectively recorded number of arousals (p = 0.004). Levels of pain and opioid use were similar in the 2 groups.CONCLUSIONS: Our objective data did not support the primary hypothesis that one night's treatment with zolpidem would significantly improve sleep architecture following major surgery, although there was improved feeling of sleep quality and fatigue associated with fewer postoperative arousals.CITATION: Krenk L; Jennum P; Kehlet H. Postoperative sleep disturbances after zolpidem treatment in fast-track hip and knee replacement.
KW - Aged
KW - Aged, 80 and over
KW - Analgesics, Opioid
KW - Arthroplasty, Replacement, Hip
KW - Arthroplasty, Replacement, Knee
KW - Double-Blind Method
KW - Fatigue
KW - Female
KW - Humans
KW - Hypnotics and Sedatives
KW - Male
KW - Middle Aged
KW - Pain, Postoperative
KW - Polysomnography
KW - Postoperative Complications
KW - Pyridines
KW - Sleep Disorders
KW - Sleep, REM
U2 - 10.5664/jcsm.3540
DO - 10.5664/jcsm.3540
M3 - Journal article
C2 - 24634631
VL - 10
SP - 321
EP - 326
JO - Journal of Clinical Sleep Medicine
JF - Journal of Clinical Sleep Medicine
SN - 1550-9389
IS - 3
ER -
ID: 138776530