Division of Respiratory Medicine, Hospital for Sick Children, Toronto, ON.
University of Toronto, Toronto, ON.
Sleep. 2018 Aug 1;41(8). doi: 10.1093/sleep/zsy094.
Previous research has suggested that general anesthetics can disturb postoperative sleep patterns by affecting the sleep-wake cycle. The objective was to identify the effects of general anesthetics on sleep quality and related behavioral changes in children.
This was a prospective, observational case-control study with children, aged 18 months to 8 years, undergoing general anesthesia for elective surgery. Participants wore an actigraph for 7 days on three occasions: prior to surgery, the immediate postoperative period, and 3 months after surgery. Data regarding behavior patterns were collected using behavioral assessments at baseline, the first postoperative week, and 3 months following surgery.
Thirty-one participants (mean age 4.8 ± 2.0 years, 81% male) underwent urologic or otolaryngologic surgery. The median (interquartile range) anesthetic duration was 132.0 (80.0-184.0) min. No significant differences were found in sleep efficiency, total sleep time, wake time after sleep onset, or sleep onset latency between baseline, 7 day postoperative period, and the 3 month follow-up. No significant differences were found in sleep-related behavioral metrics including internalizing and externalizing behaviors, and executive functioning. Data were compared with a control group of 18 participants (mean age 5.3 ± 1.8 years, 61% male). No significant differences were found in sleep patterns and related behavioral metrics between both groups.
In this study, general anesthesia did not result in disturbed sleep or associated negative behavioral changes in otherwise healthy children undergoing elective surgeries of low complexity. Physicians can advise parents that a child's surgery and associated general anesthetic exposure may not result in significant changes in postoperative sleep patterns.
既往研究提示全身麻醉可通过影响睡眠-觉醒周期干扰术后睡眠模式。本研究旨在明确全身麻醉对行择期手术患儿睡眠质量及相关行为变化的影响。
这是一项前瞻性、观察性病例对照研究，纳入年龄 18 个月至 8 岁行择期全身麻醉手术的患儿。参与者在术前、术后即刻和术后 3 个月佩戴活动记录仪 7 天。使用基线、术后第 1 周和术后 3 个月的行为评估收集行为模式相关数据。
31 名参与者（平均年龄 4.8 ± 2.0 岁，81%为男性）行泌尿外科或耳鼻喉科手术。麻醉时间中位数（四分位距）为 132.0（80.0-184.0）min。与基线、术后 7 天和术后 3 个月相比，睡眠效率、总睡眠时间、睡眠起始后清醒时间和入睡潜伏期无显著差异。包括内化和外化行为以及执行功能在内的睡眠相关行为指标也无显著差异。将数据与 18 名对照组参与者（平均年龄 5.3 ± 1.8 岁，61%为男性）进行比较。两组间睡眠模式和相关行为指标无显著差异。
在该研究中，行低复杂性择期手术的健康患儿全身麻醉后睡眠未受干扰，也无相关负面行为改变。医生可告知患儿家长，手术和全身麻醉暴露可能不会导致术后睡眠模式出现显著变化。
