Insomnia may increase anesthetic requirement

Abstract Study Objective Gamma aminobutyric acid (GABA) is the primary inhibitory neurotransmitter in the central nervous system. It is a common target for general anesthetics, and it is strongly related to the etiology of chronic insomnia. In this study, we aimed to investigate whether insomnia has any effect on anesthetic requirement, and we also assessed pain to reveal a relationship with insomnia. Design This study designed as a prospective, observational study, registered ANZCTR (ACTRN12616000241437), with institutional review board approval and written informed consent. Setting Preoperative and postoperative areas of the training and research hospital. Patients Inpatients planning to undergo laparoscopic cholecystectomy as an elective surgery were enrolled in this study. Interventions Patients were divided into 2 groups based on the results of the 4-item Jenkins Sleep Questionnaire which assesses the degree of sleep disturbance: those with or without insomnia. Anesthesia was standardized, and delivered sevoflurane concentration was adjusted according to bispectral index (BIS) value in both groups. Measurements Parameters of the study were heart rate, noninvasive arterial blood pressure, arterial oxygen saturation, BIS, end-tidal carbon dioxide, and inspiratory and end-tidal concentrations of sevoflurane at 5-minute intervals during the operation. Pain was assessed for all participants; preoperatively using 2-sided blank body manikin (front and back) and postoperatively with numeric rating scale between 0 and 10. Main Results End-tidal concentration of sevoflurane found higher in insomnia group during the maintenance phase of anesthesia. Pain experience was higher in insomnia group. In addition, postoperative abdominal pain score was higher only at 18-hour interval in insomnia group. Although BIS values were similar in both groups during surgery, mean end-tidal sevoflurane concentrations were significantly higher in insomnia group (1.48±0.20) than control group (1.23±0.18) ( P Conclusion Insomnia may result in increased anesthetic requirement and pain experience. Further study is required to identify the relationship between insomnia and anesthetics.