ArticleAnnals of medicine2023
Daytime variation in non-cardiac surgery impacts the recovery after general anesthesia.
Article in Annals of medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 10 citations in OpenAlex.
- The median Effective Dose (EDBMC anesthesiology · 2025Trial
- Preoperative nutritional status defined by GLIM criteria and postoperative delirium in older patients receiving general anesthesia.Frontiers in nutrition · 2026Article
- Risk factors associated with prolonged stay in the post-anesthesia care unit: a case-control study.Frontiers in medicine · 2026Article
- Incidence and risk factors for unplanned intensive care unit transfer from the postanesthesia care unit: a case-control study.BMC anesthesiology · 2025Article
- Efficacy and safety of hydromorphone for postoperative patient-controlled intravenous analgesia for patients undergoing orthopedic surgery: a randomized, double-blinded controlled trial.Frontiers in medicine · 2025Article
- Pre-shaping double-lumen endotracheal tubes based on video laryngoscope blade curvature enhances first-attempt intubation success rate in patients undergoing thoracoscopic surgery: a randomized controlled trial.Frontiers in medicine · 2025Article
- Effects of buccal acupuncture on postoperative analgesia in elderly patients undergoing laparoscopic radical gastrectomy: a randomized controlled trial.Frontiers in neurology · 2024Article
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Authors and funding
10 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCircadian rhythm involved with physiology has been reported to affect pharmacokinetics or pharmacodynamics. We hypothesized that circadian variations in physiology disturb anesthesia and eventually affect recovery after anesthesia.
methodsA retrospective cohort study initially included 107,406 patients (1 June 2016-6 June 2021). Patients were classified into morning or afternoon surgery groups. The primary outcome was daytime variation in PACU (post-anesthesia care unit) recovery time and Steward score. Inverse probability weighting (IPW) approach based on propensity score and univariable/multivariable linear regression were used to estimate this outcome.
resultsOf 28,074 patients, 13,418 (48%) patients underwent morning surgeries, and 14,656 (52%) patients underwent afternoon surgeries. LOWESS curves and IPW illustrated daytime variation in PACU recovery time and Steward score. Before adjustment, compared to morning surgery group, afternoon surgery group had less PACU recovery time (median [interquartile range], 57 [46, 70] Among non-cardiac surgeries, daytime variation might affect recovery after general anesthesia. These findings indicate that the timing of surgery improves recovery after general anesthesia, with afternoon surgery providing protection.KEY MESSAGESIn this retrospective cohort study of 28,074 participants, the afternoon surgery group has a higher Steward score than the morning surgery group.In multivariable linear regression, morning surgery is statistically associated with an increased PACU recovery time.Among non-cardiac surgeries, daytime variation affects the recovery after general anesthesia, with afternoon surgery providing protection.
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