ORIGINAL RESEARCH article
Front. Med.
Sec. Intensive Care Medicine and Anesthesiology
Associations of Dexmedetomidine Use, Sedation Depth, and Hemodynamic Stability with Postoperative Sleep and Emotional Recovery after Cesarean Delivery: A Prospective Observational Cohort Study
Provisionally accepted
- First Affiliated Hospital of Hebei North University, Zhangjiakou, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background: Postoperative sleep disturbance and emotional dysregulation are common in women after cesarean delivery, yet the influence of intraoperative anesthetic state on recovery remains unclear. This study examined how sedation depth, hemodynamic stability, and pain control—especially under dexmedetomidine (DEX)—affect postoperative sleep and emotional outcomes. Methods: A prospective observational cohort was conducted among 120 women undergoing elective cesarean delivery under combined spinal–epidural anesthesia. Participants were divided into DEX (n = 60) and control (n = 60) groups. Intraoperative parameters (Ramsay sedation score, mean arterial pressure [ΔMAP], heart-rate variability [ΔHR]) and postoperative pain (VAS) were recorded. Sleep quality (PSQI) and anxiety (STAI) were assessed on postoperative day 1. Multivariable regression and mediation analyses were used to evaluate associations and pathways. Results: A total of 120 women (60 per group) were analyzed. The mean postoperative PSQI and STAI scores were significantly lower in the DEX group compared with the control group (PSQI: 6.45 ± 1.34 vs. 7.18 ± 1.40; mean difference = −0.73, 95% CI −1.29 to −0.17, P = 0.012; STAI: 43.10 ± 4.73 vs. 45.37 ± 4.95; mean difference = −2.27, 95% CI −4.12 to −0.42, P = 0.018). In multivariable linear regression, DEX use remained independently associated with better postoperative sleep (β = −0.23, 95% CI −0.41 to −0.05, P = 0.012) and lower anxiety (β = −0.21, 95% CI −0.38 to −0.04, P = 0.018), while higher sedation depth (β = −0.27, 95% CI −0.45 to −0.09, P = 0.004), smaller ΔMAP (β = 0.21, 95% CI 0.03 to 0.39, P = 0.022), and lower pain intensity (β = 0.33, 95% CI 0.15 to 0.51, P = 0.001) were also significantly associated with better recovery outcomes. Conclusions: Sedation depth, hemodynamic stability, and pain control jointly determine postoperative sleep and emotional recovery following cesarean delivery. Dexmedetomidine exerts beneficial effects through both sedative and analgesic pathways. Optimizing intraoperative anesthetic state may serve as a comfort-oriented strategy to enhance maternal well-being and recovery.
Keywords: Dexmedetomidine, Cesarean Section, Sedation depth, Hemodynamic stability, Postoperative sleep, Anxiety, pain control, Maternal recovery
Received: 09 Oct 2025; Accepted: 05 Nov 2025.
Copyright: © 2025 Shaowei, XueYin, YanYan, Xiaoming, Yi, Li and Zhen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Wang Shaowei, wangshaoweisjnk@163.com
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.