Сontribution of circadian rhythms to the development of neurological disorders after prolonged anesthesia

Abstract

Despite the improvement of pre-, intra- and postoperative care methods, the problem of the development of postoperative neurological complications following prolonged anesthesia remains. A mechanism of occurrence of these complications may be circadian rhythm disorders. This article presents a review of the literature data on the prevalence, pathophysiological mechanisms, and risk factors of postoperative autonomic and circadian disorders. Notably, circadian rhythm disorders in surgical patients are observed at several levels: disruption of the sleep and wakefulness cycle, decreased melatonin secretion, instability of cortisol levels and body temperature, and changes in the vegetative balance towards sympathetic regulation. These disorders contribute to the development of postoperative pain and cognitive and anxiety-depressive disorders, hinder effective rehabilitation, and may be associated with postoperative mortality.