How does circadian rhythm affect postoperative pain after pediatric acute appendicitis surgery?

Area of Science:

• Pediatric Surgery
• Pain Management
• Chronobiology

Background:

• Postoperative pain is a significant concern in pediatric surgery.
• Circadian rhythms influence physiological processes, potentially affecting pain perception and management.
• Acute appendicitis is a common surgical emergency in children.

Purpose of the Study:

• To investigate the relationship between the timing of surgery (circadian rhythm) and postoperative pain in children undergoing acute appendicitis surgery.
• To evaluate pain scores and analgesic requirements based on surgical timing.

Main Methods:

• Prospective observational study of 186 pediatric patients (aged 6-18 years) undergoing acute appendicitis surgery.
• Patients were grouped based on surgery time: night (01:01-07:00), morning (07:01-13:00), afternoon (13:01-19:00), and evening (19:01-01:00).
• Pain was assessed using the Wong-Baker Faces Pain Rating Scale (FACEs) over 24 hours, and analgesic use was recorded.

Main Results:

• No significant differences in demographic characteristics or vital signs were observed between groups.
• Patients operated on during the night group reported significantly higher FACEs pain scores at 1, 3, 6, and 12 hours post-surgery.
• The night group required a statistically higher amount of analgesics up to 12 hours post-surgery compared to other groups.

Conclusions:

• A significant relationship exists between nighttime acute appendicitis surgery in children and circadian rhythm, impacting postoperative pain.
• Timing of surgery should be considered for effective postoperative pain management in pediatric patients.
• Further research into chronotherapy for pain relief in pediatric surgical patients is warranted.