Daytime variation in non-cardiac surgery impacts the recovery after general anesthesia
AbstractBackground Circadian rhythm involved with physiology has been reported to affect pharmacokinetics or pharmacodynamics. We hypothesized that circadian variations in physiology disturb anesthesia and eventually affect recovery after anesthesia.Methods A retrospective cohort study initially inc...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2023-12-01
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| Series: | Annals of Medicine |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/07853890.2023.2187875 |
| _version_ | 1827380537797378048 |
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| author | Feng Xu Qingtong Zhang Dongsheng Xuan Shuai Zhao Yafeng Wang Linlin Han Shiqian Huang Hongyu Zhu Tingting Wang Xiangdong Chen |
| author_facet | Feng Xu Qingtong Zhang Dongsheng Xuan Shuai Zhao Yafeng Wang Linlin Han Shiqian Huang Hongyu Zhu Tingting Wang Xiangdong Chen |
| author_sort | Feng Xu |
| collection | DOAJ |
| description | AbstractBackground Circadian rhythm involved with physiology has been reported to affect pharmacokinetics or pharmacodynamics. We hypothesized that circadian variations in physiology disturb anesthesia and eventually affect recovery after anesthesia.Methods A retrospective cohort study initially included 107,406 patients (1 June 2016–6 June 2021). Patients were classified into morning or afternoon surgery groups. The primary outcome was daytime variation in PACU (post-anesthesia care unit) recovery time and Steward score. Inverse probability weighting (IPW) approach based on propensity score and univariable/multivariable linear regression were used to estimate this outcome.Results Of 28,074 patients, 13,418 (48%) patients underwent morning surgeries, and 14,656 (52%) patients underwent afternoon surgeries. LOWESS curves and IPW illustrated daytime variation in PACU recovery time and Steward score. Before adjustment, compared to morning surgery group, afternoon surgery group had less PACU recovery time (median [interquartile range], 57 [46, 70] vs. 54 [43, 66], p < 0.001) and a higher Steward score (5.62 [5.61, 5.63] vs. 5.66 [5.65, 5.67], p < 0.001). After adjustment, compared to morning surgery group, afternoon surgery group had less PACU recovery time (58 [46, 70] vs. 54 [43, 66], p < 0.001). In multivariable linear regression, morning surgery is statistically associated with an increased PACU recovery time (coefficient, −3.20; 95% confidence interval, −3.55 to −2.86).Conclusion Among non-cardiac surgeries, daytime variation might affect recovery after general anesthesia. These findings indicate that the timing of surgery improves recovery after general anesthesia, with afternoon surgery providing protection.KEY MESSAGESIn this retrospective cohort study of 28,074 participants, the afternoon surgery group has a higher Steward score than the morning surgery group.In multivariable linear regression, morning surgery is statistically associated with an increased PACU recovery time.Among non-cardiac surgeries, daytime variation affects the recovery after general anesthesia, with afternoon surgery providing protection. |
| first_indexed | 2024-03-08T13:35:25Z |
| format | Article |
| id | doaj.art-70328d3138ed4b6eae7f5ba11d3d1feb |
| institution | Directory Open Access Journal |
| issn | 0785-3890 1365-2060 |
| language | English |
| last_indexed | 2024-03-08T13:35:25Z |
| publishDate | 2023-12-01 |
| publisher | Taylor & Francis Group |
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| series | Annals of Medicine |
| spelling | doaj.art-70328d3138ed4b6eae7f5ba11d3d1feb2024-01-16T19:13:21ZengTaylor & Francis GroupAnnals of Medicine0785-38901365-20602023-12-015511134114310.1080/07853890.2023.2187875Daytime variation in non-cardiac surgery impacts the recovery after general anesthesiaFeng Xu0Qingtong Zhang1Dongsheng Xuan2Shuai Zhao3Yafeng Wang4Linlin Han5Shiqian Huang6Hongyu Zhu7Tingting Wang8Xiangdong Chen9Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Anesthesiology, Lu’an Hospital Affiliated to Anhui Medical University, Lu’an People’s Hospital, Lu’an, ChinaDepartment of Anesthesiology, Lu’an Hospital Affiliated to Anhui Medical University, Lu’an People’s Hospital, Lu’an, ChinaDepartment of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaAbstractBackground Circadian rhythm involved with physiology has been reported to affect pharmacokinetics or pharmacodynamics. We hypothesized that circadian variations in physiology disturb anesthesia and eventually affect recovery after anesthesia.Methods A retrospective cohort study initially included 107,406 patients (1 June 2016–6 June 2021). Patients were classified into morning or afternoon surgery groups. The primary outcome was daytime variation in PACU (post-anesthesia care unit) recovery time and Steward score. Inverse probability weighting (IPW) approach based on propensity score and univariable/multivariable linear regression were used to estimate this outcome.Results Of 28,074 patients, 13,418 (48%) patients underwent morning surgeries, and 14,656 (52%) patients underwent afternoon surgeries. LOWESS curves and IPW illustrated daytime variation in PACU recovery time and Steward score. Before adjustment, compared to morning surgery group, afternoon surgery group had less PACU recovery time (median [interquartile range], 57 [46, 70] vs. 54 [43, 66], p < 0.001) and a higher Steward score (5.62 [5.61, 5.63] vs. 5.66 [5.65, 5.67], p < 0.001). After adjustment, compared to morning surgery group, afternoon surgery group had less PACU recovery time (58 [46, 70] vs. 54 [43, 66], p < 0.001). In multivariable linear regression, morning surgery is statistically associated with an increased PACU recovery time (coefficient, −3.20; 95% confidence interval, −3.55 to −2.86).Conclusion Among non-cardiac surgeries, daytime variation might affect recovery after general anesthesia. These findings indicate that the timing of surgery improves recovery after general anesthesia, with afternoon surgery providing protection.KEY MESSAGESIn this retrospective cohort study of 28,074 participants, the afternoon surgery group has a higher Steward score than the morning surgery group.In multivariable linear regression, morning surgery is statistically associated with an increased PACU recovery time.Among non-cardiac surgeries, daytime variation affects the recovery after general anesthesia, with afternoon surgery providing protection.https://www.tandfonline.com/doi/10.1080/07853890.2023.2187875Daytime variationcircadian rhythmrecovery after general anesthesiasurgery |
| spellingShingle | Feng Xu Qingtong Zhang Dongsheng Xuan Shuai Zhao Yafeng Wang Linlin Han Shiqian Huang Hongyu Zhu Tingting Wang Xiangdong Chen Daytime variation in non-cardiac surgery impacts the recovery after general anesthesia Annals of Medicine Daytime variation circadian rhythm recovery after general anesthesia surgery |
| title | Daytime variation in non-cardiac surgery impacts the recovery after general anesthesia |
| title_full | Daytime variation in non-cardiac surgery impacts the recovery after general anesthesia |
| title_fullStr | Daytime variation in non-cardiac surgery impacts the recovery after general anesthesia |
| title_full_unstemmed | Daytime variation in non-cardiac surgery impacts the recovery after general anesthesia |
| title_short | Daytime variation in non-cardiac surgery impacts the recovery after general anesthesia |
| title_sort | daytime variation in non cardiac surgery impacts the recovery after general anesthesia |
| topic | Daytime variation circadian rhythm recovery after general anesthesia surgery |
| url | https://www.tandfonline.com/doi/10.1080/07853890.2023.2187875 |
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