The Journal of Practical Medicine ›› 2022, Vol. 38 ›› Issue (14): 1793-1797.doi: 10.3969/j.issn.1006⁃5725.2022.14.015

• Clinical Research • Previous Articles     Next Articles

The relationship between perioperative circadian rhythm changes and acute pain after cesarean section and analysis of related factors

CHEN Shengjie*,ZHANG Haiyan,LIANG Huiyan,LU Ziying,LEI Hongyi.   

  1. The Second Clinical School of Medicine,Southern Medical University,Guangzhou 510280,China;Department of An⁃ esthesiology and Surgery,Shunde Women′s and Children′s Hospital of Guangdong Medical University(Shunde Mater⁃ nal and Child Health Hospital),Foshan 528300,China

  • Online:2022-07-25 Published:2022-07-25
  • Contact: LEI Hongyi E⁃mail:leihongyi2012@163.com

Abstract:

Objective The aim of this study was to explore the relationship between changes of circadian rhythm types in the perioperative period and acute pain after cesarean section. Methods A total of 148 patients who underwent cesarean section in Shunde Women′ s and Children′ s Hospital of Guangdong Medical University from November 2020 to September 2021 were recruited. The patients were grouped according to the results of the morning and evening questionnaires(MEQ⁃SA)before and 3 days after delivery. Patients with different question⁃ naire results were classified as exposure groups,and patients with the same types were the control group. Results There were 21 people in the exposure group and 127 people in the control group. The weight and BMI of the control group were higher,and there was no significant difference in age,parity,and height. The NRS score on day1 was significantly higher than that of the control group(P < 0.05). In the primipara subgroup,iatrogenic sleep interrup⁃ tions in the exposure group on the night after surgery were significantly higher than that in the control group(P < 0.05); perioperative⁃related factors such as age,height,and weight were included to construct a multivariate Logistic regression equation. The results showed that the lower the body weight(OR = 0.93,95%CI:0.89 ~ 0.97,P < 0.001), more iatrogenic sleep interruptions on the night after surgery(OR = 1.89,95%CI:1.09 ~ 3.27,P = 0.024),The higher the pain NRS score on the 1st day after surgery(OR = 2.25,95%CI:1.10 ~ 4.61,P = 0.026),are related to the higher the risk of perioperative circadian rhythm changes;patients with intermediate circadian rhythms before surgery,The risk of circadian rhythm changes was lower(OR = 0.12,95%CI:0.02 ~ 0.58,P = 0.009). Conclusion Perioperative circadian rhythm changes are associated with increased acute pain after cesarean sec⁃tion,and with body weight,iatrogenic sleep interruptions,and preoperative circadian rhythm patterns,and there is significant heterogeneity between primipara and multiparous women.

Key words:

circadian rhythm, cesarean sectionl, postoperative pain, sleep deprivation