Pain medicine (Malden, Mass.) · 2026
Impact of Adjunctive Truncal Regional Analgesia on Postoperative Sleep Quality After Total Abdominal Hysterectomy: A Prospective Observational Study.
СтатьяНазвание и аннотация: Перевод в очереди
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Güler Emine Yılmaz, Dolğun İlke, Yavuz Doğu Sevilay, Türk Simge, Şen Öznur
Аннотация
BACKGROUND: Sleep disturbances following total abdominal hysterectomy (TAH) impair recovery and satisfaction. Whether regional blocks improve postoperative sleep quality remains unexplored in gynecological surgery.
OBJECTIVES: To evaluate the effect of adjunctive regional blocks on postoperative sleep quality in patients undergoing TAH under general anesthesia.
METHODS: This prospective observational study (ClinicalTrials.gov: NCT07069322) enrolled 66 women (ASA I-II) undergoing elective TAH. After excluding six patients (two for delirium, four voluntary withdrawals), 60 were analyzed: General anesthesia alone (GA, n = 29) or with adjunctive regional block (GA+RB, n = 31). Primary outcome was Richards-Campbell Sleep Questionnaire (RCSQ) score. Secondary outcomes included Pittsburgh Sleep Quality Index (modified PSQI), Visual Analog Scale (VAS) pain scores at 1, 6, 12, and 24 hours, and satisfaction (5-point Likert).
RESULTS: Groups were demographically comparable. GA+RB had significantly higher RCSQ scores (73.0 ± 11.1 vs. 47.9 ± 16.9; P < 0.001). Postoperative modified PSQI worsened in the GA group (9.0 ± 2.4 to 11.7 ± 2.2; P < 0.001) but remained stable in GA+RB (8.1 ± 2.4 to 7.2 ± 2.3; P = 0.232). VAS scores were lower in GA+RB at all time points (all P < 0.001). Satisfaction was higher in GA+RB (4.0 ± 1.0 vs. 2.2 ± 1.2; P < 0.001). Regression identified 12-hour VAS (β = 0.56, P < 0.001) as the strongest predictor of postoperative modified PSQI.
CONCLUSIONS: Adjunctive regional blocks were associated with improved postoperative sleep quality, reduced pain, and higher patient satisfaction following TAH. Pain at 12 hours is the strongest modifiable predictor of sleep disturbance, supporting regional analgesia integration into multimodal perioperative protocols.
OBJECTIVES: To evaluate the effect of adjunctive regional blocks on postoperative sleep quality in patients undergoing TAH under general anesthesia.
METHODS: This prospective observational study (ClinicalTrials.gov: NCT07069322) enrolled 66 women (ASA I-II) undergoing elective TAH. After excluding six patients (two for delirium, four voluntary withdrawals), 60 were analyzed: General anesthesia alone (GA, n = 29) or with adjunctive regional block (GA+RB, n = 31). Primary outcome was Richards-Campbell Sleep Questionnaire (RCSQ) score. Secondary outcomes included Pittsburgh Sleep Quality Index (modified PSQI), Visual Analog Scale (VAS) pain scores at 1, 6, 12, and 24 hours, and satisfaction (5-point Likert).
RESULTS: Groups were demographically comparable. GA+RB had significantly higher RCSQ scores (73.0 ± 11.1 vs. 47.9 ± 16.9; P < 0.001). Postoperative modified PSQI worsened in the GA group (9.0 ± 2.4 to 11.7 ± 2.2; P < 0.001) but remained stable in GA+RB (8.1 ± 2.4 to 7.2 ± 2.3; P = 0.232). VAS scores were lower in GA+RB at all time points (all P < 0.001). Satisfaction was higher in GA+RB (4.0 ± 1.0 vs. 2.2 ± 1.2; P < 0.001). Regression identified 12-hour VAS (β = 0.56, P < 0.001) as the strongest predictor of postoperative modified PSQI.
CONCLUSIONS: Adjunctive regional blocks were associated with improved postoperative sleep quality, reduced pain, and higher patient satisfaction following TAH. Pain at 12 hours is the strongest modifiable predictor of sleep disturbance, supporting regional analgesia integration into multimodal perioperative protocols.