Preoperative sleep quality and inhalation anesthetic requirements: A sleep electroencephalography study

Theodor Bilharz Research Institute

Bibliographic Information

Authors: Maher M.A.; Maher E.A.; Ahmed Mahmoud A.A.

Journal: Egyptian Journal of Neurology, Psychiatry and Neurosurgery

Publisher: Egyptian Society of Neurology, Psychiatry, and Neurosurgery

Publication Date: 2015

Volume / Issue: Volume 52 / Issue 4

Pages: 254–257

ISSN: 11101083

DOI: 10.4103/1110-1083.170657

Scopus: View on Scopus

Document Type: Article

Authors and Affiliations

Maher M.A., Department of Anesthesiology, Theodor Bilharz Research Institute, Cairo, Egypt; Maher E.A., Clinical Neurophysiology Unit, Department of Neurology, Cairo University, Giza, Egypt; Ahmed Mahmoud A.A., Department of Anesthesiology, Beni Suef University, Beni Suef, Egypt

Abstract

Background On the night before surgery, poor sleep quality due to anxiety is a frequently encountered problem. Objective This study aimed at determining the effect of preoperative sleep quality on intraoperative isoflurane requirements in patients undergoing elective surgeries and also offers an electroencephalography (EEG)-based classification of sleep quality. Patients and methods Twenty-seven adult male patients scheduled for elective open cholecystectomy with ages ranging from 20 to 40 years were included in this study. The night before the operation, the patients were subjected to an at least 8 h sleep EEG, which was scored for the following: total sleep time, percentage of slow wave sleep, and percentage of rapid eye movement sleep. Intraoperative isoflurane requirements were determined by recording the amount of inspired isoflurane concentration (every 2 min) needed to achieve an intraoperative bispectral index value between 40 and 60. Patients were classified according to sleep EEG into good sleepers and bad sleepers. Isoflurane requirements were first correlated with the EEG and then compared between the two groups. Results The inspired concentration of isoflurane in good sleepers was 1.15% (1.01-1.22%), whereas in bad sleepers it was significantly lower, at 0.99% (0.87-1.18%) (P = 0.003). There was a positive correlation between isoflurane requirements and both slow wave sleep percentage (r = 0.693; P = 0.003) and rapid eye movement sleep percentage (r = 0.687; P = 0.005). Conclusion Patients suffering from poor sleep quality on the night before surgery need less intraoperatively inspired isoflurane concentration. This finding may have clinical importance in adjusting the isoflurane dose to meet patients' requirements, avoiding intraoperative complications. In addition, an EEG-based classification of sleep is offered. © 2015 The Egyptian Journal of Neurology, Psychiatry and Neurosurgery.

Keywords

Anesthesia; Isoflurane; Preoperative sleep; Sleep electroencephalography; atracurium besilate; fentanyl; propofol; adult; Article; bispectral index; cholecystectomy; clinical article; controlled study; elective surgery; electroencephalography; human; inhalation anesthesia; intraoperative period; male; observational study; preoperative period; prospective study; REM sleep; sleep quality; sleep time; slow wave sleep

Citation Information

Scopus Citations: 1

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