手术时机：影响睡眠质量，甚至术后恢复？

摘要译文（供参考）

上午手术或下午手术对老年患者术后睡眠质量和褪黑素水平的影响：

一项前瞻性随机研究

♨️目的：♨️

术后睡眠障碍不利于患者术后恢复。本研究旨在确定手术时间（上午与下午）对老年患者术后睡眠质量的影响，并分析手术时间与褪黑素水平变化之间的关系。

♨️方法：♨️

将60例接受髋关节手术的患者随机分为上午组（M组）和下午组（A组）。

睡眠质量采用Richards Campbell睡眠问卷进行评估。

手术前后，在12小时内收集夜间尿液，并测量6-硫氧基褪黑素浓度。

此外，还观察了术后谵妄（POD）的发生率。

♨️结果：♨️

术后第1、2晚，A组患者的睡眠质量得分高于M组，术后第3晚两组患者睡眠质量得分无差异（P=0.000，P=0.002，P>0.05）。

此外，在手术的第一晚，A组的尿液6-硫氧基褪黑素浓度高于M组（P=0.00）。

术后睡眠质量评分和尿6-硫氧基褪黑素浓度均显著低于术前（P=0.00，P=0.00）。

♨️结论：♨️

老年全麻髋关节手术患者术后睡眠质量评分和褪黑素水平明显低于术前。

此外，下午接受手术的患者的短期睡眠质量优于早上接受手术的病人。

这种差异可能与手术后褪黑激素水平的短期变化有关。

♨️关键词：♨️

褪黑素；睡眠质量；手术时机。

图1 CONSORT流程图。

图2两组患者术前和术后三天内RCSQ评分的比较。

图3手术前一晚、术后第一晚和第二晚各组6-SMT尿排泄量的比较。

⚜️⚜️原文摘要⚜️⚜️

The Impact of Morning Surgery or Afternoon Surgery on Postoperative Sleep Quality and Melatonin Levels of Elderly Patients:

 A Prospective, Randomized Study

♨️Objective:♨️ 

Postoperative sleep disturbance after surgery is not conducive to the recovery of patients. The purpose of this study was to determine the influence of the timing of surgery (morning vs afternoon) on the postoperative sleep quality of elderly patients and to analyze the relationship between the timing of surgery and the change in the melatonin level.

♨️Methods: ♨️

Sixty patients who received hip surgery were randomly assigned to the Morning Group (Group M) or the Afternoon Group (Group A). The sleep quality was assessed by the Richards-Campbell Sleep Questionnaire. Before and after surgery, the nocturnal urine was collected over a 12-h period, and the 6-sulfatoxymelatonin concentration was measured. Also, the incidence of postoperative delirium (POD) was observed.

♨️Results:♨️ 

On the first and second nights after surgery, the sleep quality scores of the patients in Group A were greater than those in Group M, and there was no difference in the sleep quality scores between the two groups on the third night after surgery (P=0.000, P=0.002, P>0.05, respectively). In addition, the urine 6-sulphatoxymelatonin concentration was found to be greater in Group A than in Group M on the first night of surgery (P=0.00). Both the postoperative sleep quality scores and urine 6-sulphatoxymelatonin concentration were significantly less than those before surgery (P=0.00, P=0.00).

♨️Conclusion: ♨️

The postoperative sleep quality scores and melatonin levels of elderly patients who received hip surgery under general anesthesia were significantly less than those of the patients before surgery. Furthermore, the short-term sleep quality of the patients who received surgery in the afternoon was better than that of the patients who received surgery in the morning. This difference may be related to the short-term change of the melatonin level after surgery.

♨️Keywords: ♨️

melatonin; sleep quality; timing of surgery.

Figure 1 The CONSORT flowchart.

Figure 2 Comparison of RCSQ scores before surgery and within three days after surgery between the two groups.

Figure 3 Comparison between groups of urinary excretion of 6-SMT during the night before surgery, and the first and second postoperative nights

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