Effect of Preoperative Sleep Quality on Incidence of Propofol Induced Emergence Delirium on Patients Undergoing Laparoscopic Cholecystectomy under General Anesthesia

Introduction: The postoperative emergence delirium complication occurs frequently in patients who receive general anesthesia procedures while poor sleep quality during the preoperative period may increase its frequency. The research evaluated how preoperative sleep quality would affect the emergence delirium development in patients receiving propofol anesthesia during laparoscopic cholecystectomy operations. Methodology: The research took place at Combined Military Hospital (CMH), Peshawar, where investigators studied 118 patients who received laparoscopic cholecystectomy procedures from April 2023 to March 2024. We used the Pittsburgh Sleep Quality Index (PSQI) for sleep quality evaluation prior to surgery and the Richmond Agitation-Sedation Scale (RASS) for delirium assessment in patients following anesthesia in the post-anesthesia care unit (PACU). The research used chi-square tests and independent t-tests and logistic regression for statistical analysis to explore the connection between poor sleep quality and emergence delirium rates. Result: Results showed patients with poor sleep quality according to PSQI scoring had a substantially higher emergence delirium occurrence rate of 40.7% when compared to 14.1% among other participants (p<0.001). The patients with poor sleep quality experienced higher RASS scores (2.8 ± 0.6 vs. 1.9 ± 0.5, p<0.001) along with longer emergence times (10.2 ± 3.1 min vs. 8.7 ± 2.4 min, p=0.012) and they required more time in the PACU (49.2 ± 10.1 min vs. 42.7 ± 8.4 min, p=0.004). The results of logistic regression testing indicated that poor sleep quality acted as a separate variable that significantly predicted emergence delirium with an OR of 1.87 (p=0.002). Conclusion: The quality of patient sleep during the period before surgery strongly influences the probability of emergence delirium occurring from propofol anesthesia during laparoscopic cholecystectomy operations. Patient recovery following surgery becomes optimized when they receive better sleep care prior to their operation because it lowers their risk of emergence delirium.