Comparison of Morning Operation and Evening Operation on Postoperative Sleep Quality and Pain Under General Anesthesia
Condition: Morning Operation; Evening Operation; Sleep Quality; General Anesthesia; Circadian Rhythm Sleep Disorder
MeSH terms: Sleep Wake Disorders; Sleep Disorders, Circadian Rhythm
Study type: Interventional

Summary: 
      General anesthesia is a medically induced state of low reactivity consciousness involving
      amnesia, immobility, unconsciousness, and analgesia, which is similar to natural sleep. Its
      aim is to create a state of sensory deprivation to induce a lack of motor reaction to stimuli
      and to obtain an explicit amnesia. Some studies found that general anesthesia as an
      independent risk factor could result in a desynchronization of the circadian time structure
      and cause postoperative sleep disorders characterized by reduced rapid eye movement (REM) and
      slow wave sleep (SWS), which have signiﬁcant deleterious impacts on postoperative outcomes,
      such as postoperative fatigue, severe anxiety and depression, emotional detachment and
      delirium, and even pain sensitivity or postoperative pain of patients.Several studies also
      indicated that circadian rhythms existed in human and controlled by a main internal central
      clock, the suprachiasmatic nuclei, located in the anterior hypothalamus, which produce and
      regulate biological rhythms such as sleep arousal, hormones and metabolism could also affect
      the dose of general anesthesics, which lead to different postoperative recoveries and may
      have different effects on postoperative sleep quality. Previous studies proved that
      postoperative sleep disturbances and poor sleep quality are associated with higher
      postoperative pain, changes in behavior and poor emotional well-being, which could further
      aggravate postoperative sleep quality. At present, there are few studies which are about the
      effect of circadian rhythm for different timing of surgery on intraoperative anesthestic
      requirement, postoperative sleep quality and pain under general anesthesia.
    

Detailed description: 
      eighty-four patients scheduled for elective laparoscopic abdominal surgeries under general
      anesthesia were randomly assigned to receive operation in the Day Group (8:00-12:00) and the
      Night Group (18:00-22:00). The Portable Sleep Monitor (PSM) was performed on the following 3
      nights: the night before surgery (Sleep1), the ﬁrst night after surgery (Sleep 2), and the
      third night after surgery (Sleep 3). Postoperative pain scores using visual analogue scoring
      scale, subjective sleep quality using the Athens Insomnia Scale, total dose of general
      anesthetics and postoperative adverse effect were also recorded
    

Intervention name(s): receiving operation during the day or at night
Intervention type(s): Other
Intervention description(s): eighty-four patients scheduled for elective laparoscopic abdominal surgeries under general anesthesia were randomly assigned to receive operation in the Day Group (8:00-12:00) and the Night Group (18:00-22:00)
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary purpose: Other
Keywords: morning operation; evening operation; sleep quality; general anesthesia; circadian rhythm