General Anesthetics Effects on Circadian Temporal Structure: An Update

Abstract

Disruptions of circadian and biological rhythms as well as general anesthesia can induce sleep disorders, resulting in an increase in sleepiness and drowsiness and a decrease in vigilance. It has been previously shown that circadian time can influence the pharmacologic sensitivity and the duration of action of general anesthetics. Studies on interactions between general anesthesia and circadian rhythms are few, but all of them suggest an important role of general anesthetics on circadian rhythms. General anesthesia is a particular wake-sleep state that could potentially alter circadian rhythms on the days following anesthesia. The aim of this review is to discuss the various effects of general anesthesia on animal and human circadian time structure. This topic is highly relevant to clinicians, especially those involved in that field of ambulatory practice responsible for post-operative patient care, including patient recovery and fatigue.

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“…A growing body of evidence supports a strong association between surgery under general anesthesia and disturbances in circadian rhythms, which is likely to result in sleep problems and cognitive dysfunctions after surgery [17,18]. Specific medications used during general anesthesia are thought to play a role in these circadian disruptions.…”

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“…Indeed, the literature reveals an altered pattern of melatonin secretion after anesthesia and surgery. 1 It is possible that pathological variation in melatonin levels or a disturbed circadian rhythm may modify the predisposition, severity, course, or outcome of postoperative complications, especially postoperative delirium, which is multifactorial.…”

“…1 Delirium and perioperative sleep disturbance are potentially linked -either as predisposing factors or as symptoms of one another. Thus, restoring normal sleeping patterns with a substance that is capable of resynchronizing circadian rhythm may possibly reduce the incidence of postoperative delirium or improve its outcome.…”

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