Effect of Circadian Rhythm and Sleep Quality on Post-operative Pain in Patients with Spinal Anesthesia

Abstract

Objective: In our study, we aimed to investigate the effects of circadian rhythm and sleep quality on post-operative pain in patients who will undergo minor pelvic surgery under spinal anesthesia. Methods: The prospective study includes 60 patients, aged 18–65, American Society of Anesthesiologists (ASA) I-III, whose operation was planned by general surgery and urology by applying spinal anesthesia, and divided into two groups, 30 in the morning and 30 in the afternoon, according to the time of surgery. Sleep quality with preoperative Pittsburgh Sleep Quality Index (PUKI), demographic data, preoperative and peroperative heart rate, systolic, diastolic blood pressure, peripheral oxygen saturation values, post-operative 0th, 6th, 12th, 24th h Visual Analog Scale (VAS) scores, the total amount of analgesic used in the first 24 h postoperatively, and time to first and second analgesic needs were recorded. Results: It was determined that 24 (40%) of the patients had good sleep quality according to PUKI. When the patients were grouped as those who had surgery in the morning and after-noon, no significant difference was found between the groups in terms of age, gender, ASA, and sleep quality. When the correlation between PUKI scores and VAS scores was examined, no correlation was observed. In the morning group, VAS0 (p=0.005), VAS6 (p<0.001), and VAS24 (p=0.04) values were lower, post-operative analgesic requirement was less, and the time to first and second analgesic requirement was longer. It was found that there was no significant difference in terms of quality. Conclusion: As a result, it was concluded that if the anesthetic agents we use are applied at selected times, the treatments can be more effective, the drugs can be arranged according to the application hours to optimize the effectiveness of the agents and perhaps reduce their toxic effects, and that more comprehensive studies, especially including night studies, should be done.