BACKGROUND
Postoperative sleep disturbances are common after gynecological laparoscopic surgery, possibly delaying recovery. This study evaluated whether additional postoperative administration of dexmedetomidine hydrochloride nasal spray could improve anxiety, sleep quality, and early recovery in patients who routinely received preoperative dexmedetomidine hydrochloride nasal spray.
MATERIAL AND METHODS
In this prospective, single-blind, randomized, controlled, single-center study, 80 patients undergoing elective gynecological laparoscopic surgery were enrolled from June 2024 to December 2024 and randomized to a control group (n=40) or dexmedetomidine group (n=40). Both groups received 50 μg dexmedetomidine hydrochloride nasal spray 30 minutes before anesthesia. The dexmedetomidine group received an additional 75 μg at 9: 30 PM on the night of surgery. Anxiety was assessed using the Hamilton Anxiety Scale (HAMA). Sleep was evaluated using the Athens Insomnia Scale (AIS) and sleep wristbands.
RESULTS
Baseline characteristics, postoperative pain, and postoperative nausea and vomiting were comparable between groups (all P>0.05). Both groups showed significantly decreased HAMA scores after preoperative medication compared with baseline (both P<0.001). Compared with controls, the dexmedetomidine group showed no significant difference in total AIS score on the night of surgery (P=0.771), but had a higher proportion of patients without subjective sleep deterioration (25.0% vs 5.0%, P=0.012), longer total sleep time (P=0.030), higher proportion of deep sleep (P=0.040), fewer awakenings (P=0.020), and shorter postoperative hospital stay (P<0.001).
CONCLUSIONS
Additional dexmedetomidine hydrochloride nasal spray on the night after surgery improved objective sleep structure and reduced subjective sleep deterioration without increasing adverse reactions.

Keywords: Anxiety; Dexmedetomidine; Gynecology; Laparoscopy; Randomized Controlled Trial; Sleep Disorders