Resumen La reducción de la duración del sueño, la mala calidad del sueño y la fatiga están relacionados con una inmunidad reducida y un aumento de los marcadores inflamatorios. Debido a su potencial para influir en la inflamación, la mala calidad del sueño y la fatiga podrían ser factores determinantes en el desarrollo de la periodontitis e incidir en la calidad de vida. Noventa y tres personas con periodontitis no tratada, además de treinta y una personas con encía sana se incluyeron en el estudio. La investigación involucró un examen clínico y un cuestionario. En el cuestionario se incluyeron información demográfica, información sobre salud bucal, hábitos de higiene bucal, el índice de calidad del sueño de Pittsburgh, la escala de sueño de Jenkins, la escala de evaluación multidimensional de la fatiga y el perfil de impacto en la salud bucal-14. Los pacientes fueron diagnosticados en base al Taller Mundial 2017 sobre la Clasificación de Enfermedades y Condiciones Periodontales y Periimplantarias. No se revelaron diferencias estadísticamente significativas entre la calidad del sueño, la fatiga, la calidad de vida relacionada con la salud bucal y el grado de etapa de la periodontitis (p<0,05). Sin embargo, el grupo de periodontitis tuvo puntajes más altos en el Perfil de Impacto en la Salud Oral-14 (p<0.05). Se observó una duración del sueño significativamente menor desde el punto de vista estadístico en el grupo de periodontitis en estadio IV que en los otros grupos (p<0,05). Se observó una correlación positiva estadísticamente significativa entre el Índice de Calidad del Sueño de Pittsburgh y las puntuaciones de los otros cuestionarios (p<0,05). La etapa de la periodontitis puede afectar la duración del sueño.

Abstract Reduced sleep duration, poor sleep quality and fatigue are related to reduced immunity and increased inflammatory markers. Due to its potential to influence inflammation, poor sleep quality and fatigue could be factors for periodontitis and quality of life. Ninety-three individuals with untreated periodontitis and thirty-one individuals with healthy gingiva were included in the study. The research involved a clinical examination and a questionnaire. Demographic information, information on oral health, oral hygiene habits, the Pittsburgh Sleep Quality Index, Jenkins Sleep Scale, Multidimensional Assessment of Fatigue Scale, and Oral Health Impact Profile-14 were included in the questionnaire. Patients were diagnosed based on the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. No statistically significant difference was revealed between sleep quality, fatigue, oral health related quality of life, and stage-grade of periodontitis (p<0.05). However, periodontitis group had higher Oral Health Impact Profile-14 scores (p<0.05). A statistically significantly lower sleep duration was observed in stage IV periodontitis group than the other groups (p<0.05). A statistically significant positive correlation was observed between the Pittsburgh Sleep Quality Index and the scores of the other questionnaires (p<0.05). The stage of periodontitis may impact sleep duration.

JUSTIFICATIVA E OBJETIVOS: A instrumentação em cirurgias de correção de deformidades da coluna vertebral tem risco de 0,5 a 5% de lesionar a medula espinhal. O teste de despertar é usado para a detecção precoce dessas lesões. Neste estudo comparamos os efeitos de propofol e midazolam durante o teste de despertar em cirurgia de escoliose. MÉTODOS: Trinta pacientes foram designados de forma aleatória para os grupos P e M. A anestesia foi induzida com propofol (2,5 mg kg-1) no grupo P ou midazolam (0,5 mg kg-1) no grupo M, com remifentanil (0,5 µg kg-1) e cisatracúrio (0,15 mg kg-1) em ambos os grupos. A manutenção da anestesia foi feita com O2/ar e infusões de remifentanil e cisatracúrio. Nos grupos P e M, respectivamente, doses de propofol (6-10 mg kg-1 h-1) e de midazolam (0,5 mg mg kg-1) foram preferidas. Aproximadamente 15 min antes do teste de despertar, todos os medicamentos foram interrompidos. No teste de despertar, o anestesiologista pedia ao paciente que abrisse os olhos e apertasse sua mão a cada 30 s até que o paciente respondesse. Depois, o paciente era solicitado a mexer os dedos dos pés. Os parâmetros hemodinâmicos, o tempo de abertura dos olhos e o movimento apropriado sob comando verbal foram avaliados. A frequência do BIS foi registrada durante toda a cirurgia. RESULTADOS: O tempo de abertura dos olhos foi de 9 ± 2,15 min no grupo P e de 7 ± 3,15 min no grupo M. O tempo de movimento motor foi de 12 ± 2,55 min no grupo P e de 21,25 ± 3,93 min no grupo M. CONCLUSÃO: Propofol proporcionou melhores condições de despertar e possibilitou uma melhor avaliação neurológica dentro dos mesmos valores do BIS que midazolam.

BACKGROUND AND OBJECTIVES: Instrumentation in correction operations for spinal deformities carries a 0.5-5% risk of injuring the spinal cord. The wake-up test is used for early detection of these injuries. In this study we compared the effects of propofol and midazolam during wake-up test in scoliosis surgery. METHODS: Thirty patients were randomly assigned as group P and group M. Anesthesia was induced with propofol 2.5 mg kg-1 for group P or midazolam 0.5 mg kg-1 for group M with remifentanil 0.5 µg kg-1 and cisatracurium 0.15 mg kg-1 for both groups. At the maintenance of anesthesia O2/air and infusions of remifentanil and cisatracurium were used. In group P, propofol 6-10 mg kg-1 h-1 and in group M, midazolam 0.5 mg mg kg-1 were preferred. Approximately 15 min before the wake-up test, all drugs were discontinued. At the wake-up test, anesthesiologist asked the patients to open their eyes and squeeze his/her hand at every 30 s until the patients responded. Then patients were told to wiggle their toes. Hemodynamic parameters, time of eye-opening, appropriate movement upon verbal command were evaluated. BIS frequency throughout the operation was recorded. RESULTS: The eye opening time was 9 ± 2.15 min in group P and 7 ± 3.15 min in group M. Motor movement time was 12 ± 2.55 min in group P and 21.25 ± 3.93 min in group M. CONCLUSION: Propofol provided better wake-up conditions and conducted a better neurologic assessment within the same BIS values than midazolam.