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How does general anaesthesia affect the circadian clock?

Raewyn C Poulsen1, Guy R Warman2, Jamie Sleigh3

  • 1Dept of Medicine, University of Auckland, Auckland, New Zealand.

Sleep Medicine Reviews
|February 7, 2017
PubMed
Summary
This summary is machine-generated.

General anesthesia (GA) disrupts the body's internal clock, affecting sleep patterns in post-operative patients. Further research is needed to understand how anesthesia impacts the molecular clock and patient recovery.

Keywords:
Brain and muscle ARNT-like 1Clock genesGABAHypnotic drugsNMDAPost-operative sleep disruptionSleep/wake cycleSuprachiasmatic nucleusZeitgeber

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Area of Science:

  • Neuroscience
  • Chronobiology
  • Anesthesiology

Background:

  • Post-operative patients frequently experience sleep disturbances.
  • Animal studies suggest general anesthesia (GA) disrupts circadian rhythms and molecular clock function.
  • Anesthesia is a potential contributor to post-operative circadian disruption.

Purpose of the Study:

  • To review the effects of anesthesia on the circadian clock and its rhythms.
  • To summarize current findings on anesthesia and circadian disruption.
  • To propose potential mechanisms mediating these effects.

Main Methods:

  • Review of existing animal studies on anesthesia and circadian rhythms.
  • Analysis of effects on neurotransmitter systems (GABA/NMDA).
  • Investigation of core clock gene expression (per2) and related pathways (GSK3β).

Main Results:

  • GA significantly impacts neurotransmitter systems involved in circadian control.
  • GA inhibits the expression of the core clock gene per2, potentially via the NMDA/GSK3β pathway.
  • Anesthesia's effects on circadian rhythms are more pronounced during active phases and may differ under free-running vs. entrained conditions.

Conclusions:

  • General anesthesia demonstrably affects the molecular circadian clock.
  • The precise mechanisms linking anesthesia-induced molecular changes to behavioral outcomes require further elucidation.
  • Systematic, multi-level studies (molecular, behavioral, clinical) are essential for understanding post-operative implications.