Does sleep matter before surgery? The impact of preoperative sleep quality on pain and analgesic requirement after percutaneous nephrolithotomy.

PURPOSE: Postoperative pain is a significant clinical issue that delays recovery and increases the risk of complications. Sleep quality is a modifiable factor that can influence the perception of postoperative pain. This study aimed to evaluate the association between preoperative sleep quality and postoperative pain scores, analgesic consumption, and sedation demand in patients undergoing percutaneous nephrolithotomy (PCNL).

METHODS

In this prospective observational study, 92 adult patients scheduled for elective PCNL were enrolled. In the preoperative period, the Pittsburgh Sleep Quality Index (PSQI) and the Richards-Campbell Sleep Questionnaire (RCSQ) were administered, and patients' requests for sedation were recorded. Postoperative pain was assessed at 0, 6, and 24 h using the Numerical Rating Scale (NRS) during both rest and movement. The need for additional analgesic administration was also recorded.

RESULTS

Patients classified as having poor sleep quality by either PSQI or RCSQ had significantly higher pain scores at all postoperative time points during both rest and movement (p < 0.01). The incidence of additional analgesic use and sedation request was significantly higher in the poor sleep quality group. No significant differences in age, sex, BMI, or surgery duration were observed between groups.

CONCLUSION

Poor preoperative sleep quality is associated with increased postoperative pain scores, increased additional analgesic use, and more frequent sedation requests in patients undergoing PCNL. Routine assessment of sleep quality may help identify high-risk patients and optimize perioperative pain management strategies.