CLINICAL TRIAL article
Front. Pharmacol.
Sec. Obstetric and Pediatric Pharmacology
Low-Dose Dexmedetomidine Improves Postoperative Sleep and Pain in Gynecological Surgery: A Randomized Trial
Provisionally accepted
Yi Zeng1
Li Qing Li1Rui Hu1Lei Chen1Wang Yun Zhang1Sha Li1Bin Fa Yang1Feng Liu1Hong Jian Wu1Yi Guo Gao1
Tian Ye Yang2*Hui Chao Zou2*- 1Xishuangbanna Dai Autonomous Prefecture People's Hospital, Jinhong, China
- 2Yan'an Hospital Affiliated To Kunming Medical University, Kunming, China
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Background: Postoperative sleep disturbances often lead to a vicious cycle with pain, severely hindering recovery. Women, due to fluctuations in sex hormones and unique pain modulation mechanisms, are particularly vulnerable to both postoperative sleep disorders and pain. Dexmedetomidine (DEX) has shown potential in promoting sleep and providing analgesia. This study aimed to assess the impact of adding low-dose DEX to a sufentanil-based patient-controlled intravenous analgesia (PCIA) regimen on postoperative sleep quality and pain in patients undergoing gynecological surgery. Methods: In this single-center, randomized, double-blind, placebo-controlled trial, 130 patients scheduled for elective gynecological surgery were assigned to either the DS group (PCIA with DEX 0.06 μg/kg/h and sufentanil 0.04 μg/kg/h) or the S group (PCIA with sufentanil 0.04 μg/kg/h alone). The primary outcome was the incidence of sleep disturbance (Pittsburgh Sleep Quality Index global score ≥5) on the first postoperative night. Secondary outcomes included PSQI scores on postoperative nights 1 and 2, visual analog scale (VAS) pain scores at 6, 12, 24, and 48 hours, total sufentanil consumption, PCA button presses, and adverse events. Results: The incidence of sleep disturbance was significantly lower in the DS group (21.5% vs. 47.7%, P=0.002). PSQI scores on the first and second nights were also better in the DS group (P=0.020 and P=0.016, respectively). VAS pain scores at all time points were significantly lower in the DS group (P<0.05). Sufentanil consumption and PCA presses did not differ between groups. The DS group had a higher incidence of bradycardia (16.9% vs. 3.1%, P=0.009) but a lower incidence of postoperative nausea and vomiting (13.8% vs. 32.3%, P=0.013) and rescue analgesia requirement (9.2% vs. 26.2%, P=0.011). Conclusion: Adding low-dose DEX (0.06 μg/kg/h) to a sufentanil-based PCIA regimen significantly improved postoperative sleep quality, reduced pain and PONV in gynecological patients, without reducing opioid consumption. The increased bradycardia was asymptomatic and did not increase hypotension risk. This low-dose regimen represents a safe and effective multimodal analgesic strategy.
Keywords: Dexmedetomidine, Gynecologic surgery, Multimodal analgesia, Postoperative pain, Postoperative sleep disorders, Sufentanil
Received: 17 Dec 2025; Accepted: 13 Feb 2026.
Copyright: © 2026 Zeng, Li, Hu, Chen, Zhang, Li, Yang, Liu, Wu, Gao, Yang and Zou. 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:
Tian Ye Yang
Hui Chao Zou
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