ArticleAsian journal of neurosurgery2026
Impact of Perioperative Circadian Rhythm Disruption on Recovery and Complications in Skull Base Surgery: A Prospective Cohort Study.
Article in Asian journal of neurosurgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Perioperative disruption of circadian rhythm has been implicated in adverse surgical outcomes, but its relationship to recovery and complications in patients undergoing skull base surgery remains uncertain. This prospective cohort study investigates the extent of perioperative circadian disruption, its physiological markers, and its associations with recovery trajectories and postoperative complications. Materials and Methods: Eighty-two adult patients scheduled for elective skull base tumor resection were enrolled. Serial measurements of serum melatonin and cortisol were obtained preoperatively and on postoperative days 1, 3, and 7. Sleep quality (Pittsburgh Sleep Quality Index), pain scores, and postoperative complications were recorded. Patients were categorized by the degree of combined melatonin and cortisol rhythm disruption. Statistical comparisons between high and low disruption groups were performed for clinical outcomes, complications, and recovery. Results: Significant perioperative suppression of melatonin and elevation of cortisol were observed postoperatively, with a gradual trend toward baseline by day 7. Mean (SD) melatonin fell from 42.4 (18.0) pg/mL preoperatively to 19.2 (9.9) pg/mL on day 1 ( Conclusion: Perioperative circadian disruption, quantified by hormonal and sleep indices, is frequent and strongly associated with adverse outcomes following skull base surgery. Strategies to preserve circadian alignment perioperatively could improve recovery and reduce complications.
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