Effect of clock rhythm on emergence agitation and early postoperative delirium in older adults undergoing thoracoscopic lung cancer surgery: protocol for a prospective, observational, cohort study
Abstract Introduction Surgeries conducted at night can impact patients’ prognosis, and the mechanism may be related to circadian rhythm, which influence normal physiological functions and pathophysiological changes. Melatonin is primarily a circadian hormone with hypnotic and chronobiotic effects, t...
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| Format: | Article |
| Language: | English |
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BMC
2024-03-01
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| Series: | BMC Geriatrics |
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| Online Access: | https://doi.org/10.1186/s12877-024-04846-0 |
| _version_ | 1797259015933132800 |
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| author | Linghui Jiang Jie Wang Wannan Chen Zhiyao Wang Wanxia Xiong |
| author_facet | Linghui Jiang Jie Wang Wannan Chen Zhiyao Wang Wanxia Xiong |
| author_sort | Linghui Jiang |
| collection | DOAJ |
| description | Abstract Introduction Surgeries conducted at night can impact patients’ prognosis, and the mechanism may be related to circadian rhythm, which influence normal physiological functions and pathophysiological changes. Melatonin is primarily a circadian hormone with hypnotic and chronobiotic effects, thereby affecting disease outcomes through influencing the expression of inflammatory factors and biochemical metabolism. This study aims to observe the effects of circadian rhythms on emergence agitation and early postoperative delirium of older individuals undergoing thoracoscopic lung cancer surgery and explore the possible regulatory role of melatonin. Methods This prospective, observational, cohort study will involve 240 patients. Patients will be routinely divided into three groups based on the time of the surgery: T1 (8:00–14:00), T2 (14:00–20:00) and T3 group (20:00–08:00). The primary outcome will be the incidence of emergence agitation assessed via the Richmond Agitation and Sedation Scale (RASS) in the post-anesthesia care unit (PACU). Secondary outcomes will include the incidence of early postoperative delirium assessed via the Confusion Assessment Method (CAM) on postoperative day 1, pain status assessed via the numerical rating scale (NRS) in the PACU, sleep quality on postoperative day 1 and changes in perioperative plasma melatonin, clock genes and inflammatory factor levels. Postoperative surgical complications, intensive care unit admission and hospital length of stay will also be evaluated. Discussion This paper describes a protocol for investigating the effects of circadian rhythms on emergence agitation and early postoperative delirium of older individuals undergoing thoracoscopic lung cancer surgery, as well as exploring the potential regulatory role of melatonin. By elucidating the mechanism by which circadian rhythms impact postoperative recovery, we aim to develop a new approach for achieving rapid recovery during perioperative period. Trial registration The study was registered at the Chinese Clinical Trials Registry (ChiCTR2000040252) on November 26, 2020, and refreshed on September 4, 2022. |
| first_indexed | 2024-04-24T23:02:43Z |
| format | Article |
| id | doaj.art-81188144342c464f89d21d895d4a5f50 |
| institution | Directory Open Access Journal |
| issn | 1471-2318 |
| language | English |
| last_indexed | 2024-04-24T23:02:43Z |
| publishDate | 2024-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Geriatrics |
| spelling | doaj.art-81188144342c464f89d21d895d4a5f502024-03-17T12:37:40ZengBMCBMC Geriatrics1471-23182024-03-012411710.1186/s12877-024-04846-0Effect of clock rhythm on emergence agitation and early postoperative delirium in older adults undergoing thoracoscopic lung cancer surgery: protocol for a prospective, observational, cohort studyLinghui Jiang0Jie Wang1Wannan Chen2Zhiyao Wang3Wanxia Xiong4Department of Anesthesiology, Zhongshan Hospital, Fudan UniversityDepartment of Anesthesiology, Zhongshan Hospital, Fudan UniversityDepartment of Anesthesiology, Zhongshan Hospital, Fudan UniversityDepartment of Anesthesiology, Zhongshan Hospital, Fudan UniversityDepartment of Anesthesiology, Zhongshan Hospital, Fudan UniversityAbstract Introduction Surgeries conducted at night can impact patients’ prognosis, and the mechanism may be related to circadian rhythm, which influence normal physiological functions and pathophysiological changes. Melatonin is primarily a circadian hormone with hypnotic and chronobiotic effects, thereby affecting disease outcomes through influencing the expression of inflammatory factors and biochemical metabolism. This study aims to observe the effects of circadian rhythms on emergence agitation and early postoperative delirium of older individuals undergoing thoracoscopic lung cancer surgery and explore the possible regulatory role of melatonin. Methods This prospective, observational, cohort study will involve 240 patients. Patients will be routinely divided into three groups based on the time of the surgery: T1 (8:00–14:00), T2 (14:00–20:00) and T3 group (20:00–08:00). The primary outcome will be the incidence of emergence agitation assessed via the Richmond Agitation and Sedation Scale (RASS) in the post-anesthesia care unit (PACU). Secondary outcomes will include the incidence of early postoperative delirium assessed via the Confusion Assessment Method (CAM) on postoperative day 1, pain status assessed via the numerical rating scale (NRS) in the PACU, sleep quality on postoperative day 1 and changes in perioperative plasma melatonin, clock genes and inflammatory factor levels. Postoperative surgical complications, intensive care unit admission and hospital length of stay will also be evaluated. Discussion This paper describes a protocol for investigating the effects of circadian rhythms on emergence agitation and early postoperative delirium of older individuals undergoing thoracoscopic lung cancer surgery, as well as exploring the potential regulatory role of melatonin. By elucidating the mechanism by which circadian rhythms impact postoperative recovery, we aim to develop a new approach for achieving rapid recovery during perioperative period. Trial registration The study was registered at the Chinese Clinical Trials Registry (ChiCTR2000040252) on November 26, 2020, and refreshed on September 4, 2022.https://doi.org/10.1186/s12877-024-04846-0Clock rhythmEmergence agitationEarly postoperative deliriumOlder adults |
| spellingShingle | Linghui Jiang Jie Wang Wannan Chen Zhiyao Wang Wanxia Xiong Effect of clock rhythm on emergence agitation and early postoperative delirium in older adults undergoing thoracoscopic lung cancer surgery: protocol for a prospective, observational, cohort study BMC Geriatrics Clock rhythm Emergence agitation Early postoperative delirium Older adults |
| title | Effect of clock rhythm on emergence agitation and early postoperative delirium in older adults undergoing thoracoscopic lung cancer surgery: protocol for a prospective, observational, cohort study |
| title_full | Effect of clock rhythm on emergence agitation and early postoperative delirium in older adults undergoing thoracoscopic lung cancer surgery: protocol for a prospective, observational, cohort study |
| title_fullStr | Effect of clock rhythm on emergence agitation and early postoperative delirium in older adults undergoing thoracoscopic lung cancer surgery: protocol for a prospective, observational, cohort study |
| title_full_unstemmed | Effect of clock rhythm on emergence agitation and early postoperative delirium in older adults undergoing thoracoscopic lung cancer surgery: protocol for a prospective, observational, cohort study |
| title_short | Effect of clock rhythm on emergence agitation and early postoperative delirium in older adults undergoing thoracoscopic lung cancer surgery: protocol for a prospective, observational, cohort study |
| title_sort | effect of clock rhythm on emergence agitation and early postoperative delirium in older adults undergoing thoracoscopic lung cancer surgery protocol for a prospective observational cohort study |
| topic | Clock rhythm Emergence agitation Early postoperative delirium Older adults |
| url | https://doi.org/10.1186/s12877-024-04846-0 |
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