Surgery and general anaesthesia have the potential to disturb the body’s circadian timing system, which may affect postoperative outcomes. Animal studies suggest that anaesthesia could induce diurnal phase shifts, but clinical research is scarce. We hypothesised that surgery and general anaesthesia would result in peri-operative changes in diurnal sleep–wake patterns in patients. In this single-centre prospective cohort study, we recruited patients aged ≥18 years scheduled for elective surgery receiving ≥30 min of general anaesthesia. The Munich Chronotype Questionnaire and Pittsburgh Sleep Quality Index were used to determine baseline chronotype, sleep characteristics and sleep quality. Peri-operative sleeping patterns were logged. Ninety-four patients with a mean (SD) age of 52 (17) years were included; 56 (60%) were female. The midpoint of sleep (SD) three nights before surgery was 03.33 (55 min) and showed a phase advance of 40 minutes to 02.53 (67 min) the night after surgery (p < 0.001). This correlated with the midpoint of sleep three nights before surgery and was not associated with age, sex, duration of general anaesthesia or intra-operative dexamethasone use. Peri-operatively, patients had lower subjective sleep quality and worse sleep efficiency. Disruption started from one night before surgery and did not normalise until 6 days after surgery. We conclude that there is a peri-operative phase advance in midpoint of sleep, confirming our hypothesis that surgery and general anaesthesia disturb the circadian timing system. Patients had decreased subjective sleep quality, worse sleep efficiency and increased daytime fatigue.

中文翻译：

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手术和全身麻醉对睡眠-觉醒时间的影响：CLOCKS 观察性研究

手术和全身麻醉有可能扰乱身体的昼夜节律系统，这可能会影响术后结果。动物研究表明，麻醉可以诱导昼夜相移，但临床研究很少。我们假设手术和全身麻醉会导致患者在围手术期改变昼夜睡眠-觉醒模式。在这项单中心前瞻性队列研究中，我们招募了年龄≥18 岁且计划进行择期手术并接受≥30 分钟全身麻醉的患者。慕尼黑时间型问卷和匹兹堡睡眠质量指数用于确定基线时间型、睡眠特征和睡眠质量。记录围手术期睡眠模式。包括 94 名平均 (SD) 年龄为 52 (17) 岁的患者；56 人（60%）是女性。手术前三晚的睡眠中点 (SD) 为 03.33（55 分钟），并显示出 40 分钟的相位提前到手术后晚上的 02.53（67 分钟）（p < 0.001）。这与手术前三晚的睡眠中点相关，与年龄、性别、全身麻醉持续时间或术中使用地塞米松无关。围手术期，患者主观睡眠质量较低，睡眠效率较差。中断从手术前一晚开始，直到手术后 6 天才恢复正常。我们得出结论，在睡眠中点存在围手术期提前，证实了我们的假设，即手术和全身麻醉会干扰昼夜节律系统。患者的主观睡眠质量下降，睡眠效率变差，白天疲劳增加。