Effect of General Anesthesia Combined with Transversus Abdominis Plane Block on Postoperative Sleep Disorders in Elderly Patients Undergoing Gastrointestinal Tumor Surgery: A Prospective, Randomized Controlled Trial

• DOI: 10.2147/nss.s486711
• Publication Date: 2025-01-07T09:15:16Z
• Authors: Jie Pu; Chendong Guo; Yue Xiao; Yanan Cao; Zhenhua Liu; Yuzhong Jin; Yimin Hu
• Keywords: Psychiatry; Neurophysiology and neuropsychology; pittsburgh sleep quality index; Clinical Trial Report; gastrointestinal tumors; QP351-495; RC435-571; sleep disorders; elderly; transversus abdominis plane block

Abstract Purpose: This study aimed to investigate the effect of general anesthesia combined with transversus abdominis plane block on postoperative sleep disorders in elderly patients undergoing gastrointestinal tumor surgery. Methods: We recruited 94 elderly patients diagnosed with gastrointestinal malignancies, all scheduled for radical laparoscopic surgery. The patients were allocated to two groups using the random number table method: the general anesthesia group (group GA) and the general anesthesia combined with transversus abdominis plane block group (group GT). Group GT got bilateral transversus abdominis plane blocks (TAPB) following the same induction of anesthesia as Group GA, which received the intravenous-inhalation complicated general anesthesia regimen. Wearable devices were utilized to measure sleep on the first day before surgery (P1) as well as the first and third day after surgery (D1 and D3). On P1, D1, and D3 nights, respectively, the Pittsburgh Sleep Quality Index (PSQI) scale was utilized to measure sleepiness and the occurrence of postoperative sleep disorders (POSD). Results: The group GT demonstrated a significant decrease in the usage of remifentanil during surgery (P<0.05) as compared to the group GA. At D1, there was a substantial decrease in the number of awake (P<0.05) and an increase in the ratio of deep sleep to rapid eye movement sleep (REM) in the GT group. The percentage of REM was still rising at D3, and PSQI values at D1 and D3 were considerably lower (P<0.05). Furthermore, there was a decreasing tendency (P<0.05) in the incidence of POSD and the visual analog scores (VAS) at 0.5 and 6 hours after surgical activity in D1. The overall condition, intraoperative state, remedial analgesia, and number of analgesic pump presses did not differ significantly between the two groups (P>0.05). Conclusion: General anesthesia combined with transversus abdominis plane block can improve the postoperative sleep quality of elderly patients with gastrointestinal tumors and reduce the incidence of sleep disorders.