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[Effect of general anesthesia on postoperative melatonin secretion in 4-to 6-year-old children with snoring]
Qianqi Qiu1, Xingrong Song1, Changzhi Sun2
1Department of Anesthesiology, Guangzhou Women and Children's Medical Center Affiliated to Guangzhou Medical University, Guangzhou 510623, China.
Insights
General anesthesia temporarily lowers melatonin secretion in young children with snoring after surgery. However, morning surgeries do not significantly disrupt their circadian rhythm.
Area of Science:
- Pediatric Anesthesiology
- Sleep Medicine
- Endocrinology
Background:
- Snoring in children is often associated with sleep-disordered breathing.
- Melatonin, a key hormone regulating sleep-wake cycles, may be affected by anesthesia.
- Understanding anesthesia's impact on melatonin is crucial for optimizing pediatric postoperative care.
Purpose of the Study:
- To investigate the effect of general anesthesia on postoperative melatonin secretion in preschool children with snoring.
- To assess whether morning adenoidectomy under general anesthesia impacts circadian rhythm in these children.
Main Methods:
- Salivary melatonin levels were measured in 20 children (4-6 years old) with snoring at multiple time points before, during, and after adenoidectomy.
- Postoperative sleep quality, pain, and recovery were evaluated using validated questionnaires (OSA-18, FLACC, QoR-15).
- Environmental factors like illumination and body temperature were controlled and recorded.
Main Results:
- A significant decrease in salivary melatonin was observed at 7 am on the first postoperative day, which recovered by the second day.
- No significant changes in pain scores (FLACC, QoR-15) were noted, but the Sleep Apnea Life Quality Evaluation Questionnaire (OSA-18) scores improved post-surgery.
- No major adverse events related to anesthesia or surgery were reported.
Conclusions:
- General anesthesia temporarily affects, but does not completely inhibit, melatonin secretion in preschool children with snoring on the first postoperative night.
- Morning adenoidectomy under general anesthesia does not appear to cause significant, lasting disturbances in melatonin secretion or circadian rhythm in this pediatric population.
Objective:
To evaluate the effect of general anesthesia on postoperative melatonin secretion in 4-to 6-year-old children with snoring.
Methods:
Twenty children with snoring aged 4-6 years of either gender (ASA grade Ⅰ and Ⅱ) were selected for adenoidectomy.Before, during and 3 days after the operation, salivary melatonin levels of the children were measured at 11 selected time points (T1-T11).The illumination intensity and body temperature of the children were recorded at each time point of measurement.The sleep time of the children in 3 days after the operation was recorded, and postoperative pain scores (FLACC) and Riker and Rehabilitation Quality Rating Scale-15(QoR-15) scores were assessed.Sleep Apnea Life Quality Evaluation Questionnaire (OSA-18) was used to evaluate postoperative recovery of the children at 28 days after the operation.The incidence of major adverse events of the children during hospitalization was recorded.
Results:
No significant difference was found in baseline salivary melatonin level among the 20 children before the operation.Salivary melatonin level at 7 am after the operation (T8) was significantly lowered as compared with that before the surgery (T4)(P < 0.05) but recovered at 7 am on the second day after the surgery (T11);salivary melatonin levels at T4, T8, and T11 exceeded 3 pg/mL on the third day.No significant difference was found in illumination intensity or body temperature across the time points when melatonin level was measured.The children showed no significant changes in FLACC score, Riker score or QOR- 15 score after the operation, but the OSA-18 score was significantly lowered after the operation (P < 0.05).None of the 20 children had such adverse events as respiratory depression, sinus bradycardia, sinus tachycardia, hypertension, hypotension, nausea or vomiting during hospitalization.
Conclusions:
In preschool children with snoring, general anesthesia affects but does not inhibit melatonin secretion on the first night after surgery, and minor surgeries under general anesthesia in the morning do not cause significant changes in melatonin secretion to cause disturbance of the circadian rhythm in these children.
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