Вклад циркадных ритмов в развитие неврологических нарушений после длительного анестезиологического обеспечения

Автор: Мазуров Н.А., Кичерова О.А., Вербах Т.Э., Рейхерт Л.И., Доян Ю.И., Салтанова В.А.

Журнал: Клиническая практика @clinpractice

Рубрика: Обзоры

Статья в выпуске: 2 т.15, 2024 года.

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Несмотря на совершенствование методов до-, интра- и послеоперационного ухода, сохраняется проблема послеоперационных неврологических осложнений после длительного анестезиологического пособия. Одним из механизмов возникновения указанных осложнений могут быть нарушения циркадного ритма. Авторами представлен обзор литературных данных о распространённости, патофизиологических механизмах и факторах риска послеоперационных вегетативных и циркадных нарушений. Установлено, что нарушения циркадного ритма у хирургических больных наблюдаются на нескольких уровнях: нарушение цикла сна и бодрствования, снижение секреции мелатонина, нестабильность уровня кортизола и температуры тела, а также изменение вегетативного баланса в сторону симпатической регуляции. Указанные нарушения способствуют развитию постоперационной боли, неврологических, когнитивных и тревожно-депрессивных нарушений, препятствуют эффективной реабилитации и могут быть связаны с послеоперационной смертностью.

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Постоперационные неврологические нарушения, нарушения циркадного ритма, вегетативная дисфункция, нарушения сна

Короткий адрес: https://sciup.org/143183233

IDR: 143183233   |   DOI: 10.17816/clinpract630310

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