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时机很重要:剖宫产术中脊髓麻醉昼夜节律效应的观察性研究。

Timing Matters: An Observational Study on Circadian Effects of Spinal Anesthesia in Cesarean Delivery.

作者信息

Nikouli Evangelia, Koutlaki Nikoleta, Anagnostopoulos Kostas, Toubalidou Soultania Anna, Tsigalou Christina, Chloropoulou Pelagia

机构信息

Department of Anaesthesiology, General Hospital of Komotini, 69100 Komotini, Greece.

Department of Obstetrics and Gynaecology, Faculty of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece.

出版信息

Life (Basel). 2025 May 31;15(6):895. doi: 10.3390/life15060895.

Abstract

The timing of anesthesia administration may affect drug efficacy and recovery outcomes. Understanding these variations is important for optimizing anesthetic care. To assess how spinal anesthesia timing affects block duration, postoperative pain, and CRP and cortisol levels in cesarean deliveries. Ninety women were divided into three groups based on spinal anesthesia timing: Group A (08:00-16:00), Group B (16:00-00:00), and Group C (00:00-08:00). Standardized spinal anesthesia was administered. Sensory/motor blockade and pain (NRS) were assessed every 10 min. Blood samples for CRP and cortisol were collected preoperatively and at 2, 4, 24, and 48 h post operation. Group C showed shorter sensory and motor blockade than Groups A and B ( < 0.05). The time to first analgesic request was longest in Group A, while Group C reported the highest pain scores ( < 0.05). CRP levels were significantly higher in Group B vs. Group A at 24 and 48 h, and vs. Group C at 48 h ( < 0.05). Group B demonstrated the steepest CRP velocity, indicating a more rapid physiological stress response. BMI differences may have influenced biomarker dynamics. Spinal anesthesia timing significantly impacts block duration, pain experience, and the rate of the physiological stress response. CRP velocity may offer additional insights into perioperative inflammation. Circadian considerations should be integrated into anesthetic planning for cesarean deliveries.

摘要

麻醉给药时间可能会影响药物疗效和恢复结果。了解这些差异对于优化麻醉护理很重要。为了评估剖宫产术中脊髓麻醉时间对阻滞持续时间、术后疼痛以及CRP和皮质醇水平的影响。90名女性根据脊髓麻醉时间分为三组:A组(08:00 - 16:00)、B组(16:00 - 00:00)和C组(00:00 - 08:00)。实施标准化脊髓麻醉。每10分钟评估一次感觉/运动阻滞和疼痛(数字评分量表)。术前以及术后2、4、24和48小时采集用于检测CRP和皮质醇的血样。C组的感觉和运动阻滞时间比A组和B组短(<0.05)。A组首次要求镇痛的时间最长,而C组的疼痛评分最高(<0.05)。B组在24小时和48小时时的CRP水平显著高于A组,在48小时时显著高于C组(<0.05)。B组的CRP变化速度最快,表明生理应激反应更快。体重指数差异可能影响了生物标志物动态变化。脊髓麻醉时间显著影响阻滞持续时间、疼痛体验和生理应激反应速度。CRP变化速度可能为围手术期炎症提供更多见解。昼夜节律因素应纳入剖宫产的麻醉计划中。

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