Dexmedetomidine for improving postpartum sleep quality following cesarean section in women: a randomized controlled trial

Background Perinatal sleep disturbance is highly prevalent among women undergoing elective cesarean section. Dexmedetomidine has been proven effective in improving sleep quality in patients undergoing general surgery, and this study aimed to investigate its potential efficacy in improving postoperative sleep quality in the elective cesarean section population. Methods A total of 68 parturients scheduled for elective cesarean section were randomly allocated to the dexmedetomidine group (Group D) and the control group (Group C). Following fetal delivery, Group D received an intravenous bolus infusion of 0.5 μg/kg dexmedetomidine within 15 min, while Group C was administered an equal volume of normal saline as a control. Outcome measures included sleep quality scores at 1st, 2nd, 3rd day and 6th week postoperatively, STAI score at 1st, 2nd and 3rd day postoperatively, resting and activity-related pain scores at 24 h postoperatively, 24-h consumption of patient-controlled PCEA, the incidence of intraoperative shivering, EPDS scores at 6th week postoperatively and NBNA scores within 24 h/48 h after surgery. All outcomes were systematically recorded and compared between the two groups. Results Group D had significantly higher sleep quality scores than Group C at the first postoperative night and 6th week postoperatively ( p < 0.001 and p = 0.01, respectively). At 24 h postoperatively, Group D exhibited lower activity-related pain scores and reduced 24-h PCEA consumption compared with Group C (both p < 0.001), and postoperative anxiety levels were significantly decreased in Group D on the first postoperative day ( p < 0.05). No significant difference was observed in EPDS scores between the two groups at 6th week postoperatively. Additionally, the incidence of intraoperative shivering was markedly lower in Group D than in Group C ( p < 0.001) and the NBNA scores were similar between Group D and Group C. Conclusion For parturients undergoing elective cesarean section, intraoperative intravenous bolus infusion of dexmedetomidine exerts a positive effect on improving sleep quality at the first postoperative night and 6th week postoperatively, as well as reducing activity-related pain scores at 24 h postoperatively. Clinical trial registration Chinese Clinical Trial Registry (ChiCTR2500106212) https://www.chictr.org.cn/showprojEN.html?proj=280761 .