Improved Pittsburgh Sleep Quality Index scores on first postoperative night achieved by propofol anesthesia in patients undergoing ambulatory gynecologic surgery

BACKGROUND: Sleep disturbance on the first postoperative night commonly develops for patients after day surgeries. The choice of either total intravenous anesthesia by propofol or total inhalation anesthesia with sevoflurane has become an issue for preventing sleep disturbance. AIM: To compare sleep quality on the first postoperative night for female patients after total intravenous anesthesia by propofol and total inhalation anesthesia with sevoflurane. METHODS: We enrolled 61 American Society of Anesthesia (ASA) class I-II outpatients who underwent minor gynecologic surgeries by either propofol or sevoflurane anesthesia. Sleep quality of the very night was assessed by the Pittsburgh Sleep Quality Index (PSQI) on the next day, and PSQI scores were compared by the Wilcoxon signed-rank test and paired t-test pre-operatively and postoperatively. RESULTS: For the propofol group, the mean postoperative global PSQI score (3.3 ± 1.3) was lower than the mean preoperative global PSQI score (4.9 ± 2.3) (P < 0.001); for the sevoflurane group, the mean postoperative global PSQI score (6.5 ± 2.8) was higher than the mean preoperative global PSQI score (5.5 ± 3.2) (P = 0.02). Eighty percent of patients receiving propofol anesthesia subjectively reported improved sleep quality, but only 17% of patients receiving sevoflurane anesthesia reported improved sleep quality. CONCLUSION: Sleep quality assessed by the PSQI is better improved in ASA class I-II female patients receiving propofol anesthesia other than sevoflurane anesthesia for undergoing minor gynecologic surgeries.