Effects of circadian rhythm on Narcotrend index and target-controlled infusion concentration of propofol anesthesia
Abstract Background The effects of circadian rhythms on drug metabolism and efficacy are being increasingly recognized. However, the extent to which they affect general anesthesia remains unclear. This study aims to investigate the effects of circadian rhythms on anesthetic depth and the concentrati...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-09-01
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| Series: | BMC Anesthesiology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12871-021-01445-z |
| _version_ | 1819128997509857280 |
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| author | Jiang-hua Shen Min Ye Qian Chen Yan Chen Hai-lin Zhao Ameena Khan Bin Yi Jiao-lin Ning Kai-zhi Lu Jian-teng Gu |
| author_facet | Jiang-hua Shen Min Ye Qian Chen Yan Chen Hai-lin Zhao Ameena Khan Bin Yi Jiao-lin Ning Kai-zhi Lu Jian-teng Gu |
| author_sort | Jiang-hua Shen |
| collection | DOAJ |
| description | Abstract Background The effects of circadian rhythms on drug metabolism and efficacy are being increasingly recognized. However, the extent to which they affect general anesthesia remains unclear. This study aims to investigate the effects of circadian rhythms on anesthetic depth and the concentrations of propofol target-controlled infusion (TCI). Methods Sixty patients undergoing laparoscopic surgeries were sequentially assigned to four groups. Group ND (n = 15): Propofol TCI with Narcotrend monitor during the day (8:00–18:00), Group NN (n = 15): Propofol TCI with Narcotrend monitor during the night (22:00–5:00), Group CLTD (n = 15): Propofol closed-loop TCI guided by bispectral index (BIS) during the day (8:00–18:00), Group CLTN (n = 15): Propofol closed-loop TCI guided by BIS during the night (22:00–5:00). The Narcotrend index, mean arterial pressure (MAP) and heart rate (HR) were compared between group ND and NN at 7 time points, from 5 min before induction to the end of operation. The propofol TCI concentrations, MAP and HR were compared between group CLTD and CLTN at 7 time points, from 5 min after induction to the end of operation. Results The Narcotrend index, MAP, and HR in group NN were lower than those in group ND from the beginning of mechanical ventilation to the end of operation (p < 0.05). The propofol TCI concentrations in group CLTN were lower than those in group CLTD from the beginning of operation to the end of operation (p < 0.05). Conclusion Circadian rhythms have a significant effect on the depth of anesthesia and drug infusion concentrations during propofol TCI. When using general anesthesia during night surgery, the propofol infusion concentration should be appropriately reduced compared to surgery during the day. Trial registration The present study was registered on the ClinicalTrials.gov website ( NCT02440269 ) and approved by the Medical Ethics Committee of Southwest Hospital of Third Military Medical University (ethics lot number: 2016 Research No. 93). All patients provided informed written consent to participate in the study. |
| first_indexed | 2024-12-22T08:36:43Z |
| format | Article |
| id | doaj.art-93f7832d955943d0be8a7edaad504428 |
| institution | Directory Open Access Journal |
| issn | 1471-2253 |
| language | English |
| last_indexed | 2024-12-22T08:36:43Z |
| publishDate | 2021-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Anesthesiology |
| spelling | doaj.art-93f7832d955943d0be8a7edaad5044282022-12-21T18:32:20ZengBMCBMC Anesthesiology1471-22532021-09-012111910.1186/s12871-021-01445-zEffects of circadian rhythm on Narcotrend index and target-controlled infusion concentration of propofol anesthesiaJiang-hua Shen0Min Ye1Qian Chen2Yan Chen3Hai-lin Zhao4Ameena Khan5Bin Yi6Jiao-lin Ning7Kai-zhi Lu8Jian-teng Gu9Department of Anesthesiology, Southwest Hospital, Third Military Medical University (Army Medical University)Department of Anesthesiology, Southwest Hospital, Third Military Medical University (Army Medical University)Department of Anesthesiology, Southwest Hospital, Third Military Medical University (Army Medical University)Department of Anesthesiology, Southwest Hospital, Third Military Medical University (Army Medical University)Division of Anesthetics, Pain Medicine and Intensive Care, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, Chelsea & Westminster HospitalDivision of Anesthetics, Pain Medicine and Intensive Care, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, Chelsea & Westminster HospitalDepartment of Anesthesiology, Southwest Hospital, Third Military Medical University (Army Medical University)Department of Anesthesiology, Southwest Hospital, Third Military Medical University (Army Medical University)Department of Anesthesiology, Southwest Hospital, Third Military Medical University (Army Medical University)Department of Anesthesiology, Southwest Hospital, Third Military Medical University (Army Medical University)Abstract Background The effects of circadian rhythms on drug metabolism and efficacy are being increasingly recognized. However, the extent to which they affect general anesthesia remains unclear. This study aims to investigate the effects of circadian rhythms on anesthetic depth and the concentrations of propofol target-controlled infusion (TCI). Methods Sixty patients undergoing laparoscopic surgeries were sequentially assigned to four groups. Group ND (n = 15): Propofol TCI with Narcotrend monitor during the day (8:00–18:00), Group NN (n = 15): Propofol TCI with Narcotrend monitor during the night (22:00–5:00), Group CLTD (n = 15): Propofol closed-loop TCI guided by bispectral index (BIS) during the day (8:00–18:00), Group CLTN (n = 15): Propofol closed-loop TCI guided by BIS during the night (22:00–5:00). The Narcotrend index, mean arterial pressure (MAP) and heart rate (HR) were compared between group ND and NN at 7 time points, from 5 min before induction to the end of operation. The propofol TCI concentrations, MAP and HR were compared between group CLTD and CLTN at 7 time points, from 5 min after induction to the end of operation. Results The Narcotrend index, MAP, and HR in group NN were lower than those in group ND from the beginning of mechanical ventilation to the end of operation (p < 0.05). The propofol TCI concentrations in group CLTN were lower than those in group CLTD from the beginning of operation to the end of operation (p < 0.05). Conclusion Circadian rhythms have a significant effect on the depth of anesthesia and drug infusion concentrations during propofol TCI. When using general anesthesia during night surgery, the propofol infusion concentration should be appropriately reduced compared to surgery during the day. Trial registration The present study was registered on the ClinicalTrials.gov website ( NCT02440269 ) and approved by the Medical Ethics Committee of Southwest Hospital of Third Military Medical University (ethics lot number: 2016 Research No. 93). All patients provided informed written consent to participate in the study.https://doi.org/10.1186/s12871-021-01445-zCircadian rhythmPropofolTarget controlled infusionDepth of anesthesia |
| spellingShingle | Jiang-hua Shen Min Ye Qian Chen Yan Chen Hai-lin Zhao Ameena Khan Bin Yi Jiao-lin Ning Kai-zhi Lu Jian-teng Gu Effects of circadian rhythm on Narcotrend index and target-controlled infusion concentration of propofol anesthesia BMC Anesthesiology Circadian rhythm Propofol Target controlled infusion Depth of anesthesia |
| title | Effects of circadian rhythm on Narcotrend index and target-controlled infusion concentration of propofol anesthesia |
| title_full | Effects of circadian rhythm on Narcotrend index and target-controlled infusion concentration of propofol anesthesia |
| title_fullStr | Effects of circadian rhythm on Narcotrend index and target-controlled infusion concentration of propofol anesthesia |
| title_full_unstemmed | Effects of circadian rhythm on Narcotrend index and target-controlled infusion concentration of propofol anesthesia |
| title_short | Effects of circadian rhythm on Narcotrend index and target-controlled infusion concentration of propofol anesthesia |
| title_sort | effects of circadian rhythm on narcotrend index and target controlled infusion concentration of propofol anesthesia |
| topic | Circadian rhythm Propofol Target controlled infusion Depth of anesthesia |
| url | https://doi.org/10.1186/s12871-021-01445-z |
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