ArticleBMC geriatrics2024
Effect of clock rhythm on emergence agitation and early postoperative delirium in older adults undergoing thoracoscopic lung cancer surgery: protocol for a prospective, observational, cohort study.
Article in BMC geriatrics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed, 4 citations in OpenAlex.
- Protective Effect of Dexmedetomidine Combined with Butorphanol on Perioperative Pulmonary Function in Patients Undergoing Laparoscopic Colorectal Cancer Resection: A Randomized, Double-Blind, 2 * 2 Factorial-Controlled Trial.Drug design, development and therapy · 2025Trial
- A nomogram and risk stratification for predicting subsyndromal delirium in elderly patients in a post-anaesthesia care unit: A prospective cohort study.International journal of nursing studies advances · 2025Article
- The impact of postoperative pain interventions on circadian rhythm disruptions: mechanisms and clinical implications.Frontiers in neuroscience · 2025Review
- Effect of the postoperative pain management model on the psychological status and quality of life of patients in the advanced intensive care unit.BMC nursing · 2024Article
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
introductionSurgeries conducted at night can impact patients' prognosis, and the mechanism may be related to circadian rhythm, which influence normal physiological functions and pathophysiological changes. Melatonin is primarily a circadian hormone with hypnotic and chronobiotic effects, thereby affecting disease outcomes through influencing the expression of inflammatory factors and biochemical metabolism. This study aims to observe the effects of circadian rhythms on emergence agitation and early postoperative delirium of older individuals undergoing thoracoscopic lung cancer surgery and explore the possible regulatory role of melatonin.
methodsThis prospective, observational, cohort study will involve 240 patients. Patients will be routinely divided into three groups based on the time of the surgery: T1 (8:00-14:00), T2 (14:00-20:00) and T3 group (20:00-08:00). The primary outcome will be the incidence of emergence agitation assessed via the Richmond Agitation and Sedation Scale (RASS) in the post-anesthesia care unit (PACU). Secondary outcomes will include the incidence of early postoperative delirium assessed via the Confusion Assessment Method (CAM) on postoperative day 1, pain status assessed via the numerical rating scale (NRS) in the PACU, sleep quality on postoperative day 1 and changes in perioperative plasma melatonin, clock genes and inflammatory factor levels. Postoperative surgical complications, intensive care unit admission and hospital length of stay will also be evaluated. DISCUSSION: This paper describes a protocol for investigating the effects of circadian rhythms on emergence agitation and early postoperative delirium of older individuals undergoing thoracoscopic lung cancer surgery, as well as exploring the potential regulatory role of melatonin. By elucidating the mechanism by which circadian rhythms impact postoperative recovery, we aim to develop a new approach for achieving rapid recovery during perioperative period.
trial registrationThe study was registered at the Chinese Clinical Trials Registry (ChiCTR2000040252) on November 26, 2020, and refreshed on September 4, 2022.
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