Circadian Timing of Spinal Anaesthesia Affects Analgesia and Inflammatory Response in Cesarean Delivery |Chapter 7 | Medical Science: Updates and Prospects Vol. 5

 

Background: The timing of anaesthesia administration may influence both drug efficacy and postoperative recovery, and understanding these temporal variations is essential for optimising anaesthetic management and patient outcomes. In particular, circadian physiology modulates cardiovascular stress responses, immune function, hormonal secretion, and the pharmacokinetics and pharmacodynamics of anaesthetic agents, as well as pain perception, making time of day a potentially important determinant of perioperative outcomes. However, evidence on circadian effects in neuraxial anaesthesia for cesarean delivery remains limited, particularly regarding inflammatory and stress markers, highlighting the need to determine whether anaesthesia administration time affects block characteristics, postoperative pain, and biomarkers such as CRP and cortisol.

 

Aim: To assess how spinal anaesthesia timing affects block duration, postoperative pain, and CRP and cortisol levels in cesarean deliveries.

Methods: Ninety women were divided into three groups based on spinal anaesthesia timing: Group A (08:00–16:00), Group B (16:00–00:00), and     Group C (00:00–08:00). Standardised spinal anaesthesia was administered. Sensory/motor blockade and pain (NRS) were assessed every 10 minutes. Blood samples for CRP and cortisol were collected preoperatively and at 2, 4, 24, and 48 hours postoperatively.

 

Results: Group C showed shorter sensory and motor blockade than Groups A and B (p<0.05). Time to first analgesic request was longest in Group A, while Group C reported the highest pain scores (p<0.05). CRP levels were significantly higher in Group B vs. Group A at 24 and 48 hours, and vs. Group C at 48 hours (p<0.05). Group B demonstrated the steepest CRP velocity, indicating a more rapid physiological stress response. BMI differences may have influenced biomarker dynamics.

 

Conclusion: Cesarean sections performed under spinal anaesthesia during the early daytime were associated with prolonged sensory and motor block, lower postoperative pain scores, and a more favourable CRP profile compared with procedures later in the day. In contrast, late‑afternoon and nighttime anaesthesia were linked to shorter block duration, higher pain scores, and increased inflammatory responses, with the most pronounced CRP increase observed in the late‑afternoon group. Distinct BMI–CRP correlation patterns across time groups further indicated that both the timing of spinal anaesthesia and patient characteristics shape the perioperative inflammatory profile. These findings indicate that time of day is a clinically relevant, modifiable factor in neuraxial anaesthesia for cesarean delivery and suggest that scheduling spinal anaesthesia in earlier daytime windows may optimise block quality, postoperative analgesia, and inflammatory response.

 

 

Author(s) Details

Evangelia Nikouli
Department of Anaesthesiology, General Hospital of Komotini, Thrace, Greece.

 

Nikoleta Koutlaki
Department of Obstetrics and Gynaecology, Faculty of Medicine, Democritus University of Thrace, Greece.

 

Kostas Anagnostopoulos
Laboratory of Biochemistry, Faculty of Medicine, Democritus University of Thrace, Greece.

 

Soultania Anna Toubalidou
Faculty of Social, Political and Economic Sciences-Democritus University of Trace, Komotini, Thrace, Greece.

 

Christina Tsigalou
Laboratory of Hygiene and Environmental Protection, Department of Medicine, Democritus University of Thrace, Greece.

 

Pelagia Chloropoulou
Department of Anesthesiology, Alexandroupolis University Hospital, Democritus University of Thrace, 68100 Alexandroupolis, Greece.

 

 

Please see the book here :- https://doi.org/10.9734/bpi/msup/v5/6992

Chronotypes and Health: Biological and Social Implications | Chapter 6 | An Overview of Disease and Health Research Vol. 6

 

Chronotypes represent an individual’s natural preference for sleep and activity timing within the 24-hour day, governed by circadian rhythms and the suprachiasmatic nucleus (SCN). This review explores how chronotypes categorised as morning, evening, and intermediate affect various dimensions of health and behaviours. It examines the biological underpinnings of chronotype, including hormonal and genetic mechanisms, and the tools used for its assessment, such as the Morningness-Eveningness Questionnaire, Munich Chronotype Questionnaire, actigraphy, and sleep diaries. The study highlights significant associations between chronotype and physical health outcomes, including sleep quality, metabolic disorders, cardiovascular health, and immune function. In terms of mental health, evening chronotypes are particularly vulnerable to depression, anxiety, and stress-related disorders, often due to misalignment between biological rhythms and societal demands. Furthermore, chronotype influences cognitive functioning, academic performance, and the impact of shift work, particularly among working adults. Understanding and aligning daily routines with an individual’s chronotype can lead to improved well-being, enhanced productivity, and reduced health risks. The findings underscore the importance of recognising chronotype differences to improve health outcomes, optimise daily functioning, and tailor interventions in educational, clinical, and occupational settings. Future research should continue to explore chronotype-based interventions and policies that respect biological diversity in human functioning.

 

 

Author(s) Details

Sambid Sunamajhi
Kalinga Institute of Social Sciences Deemed to be University, Bhubaneswar, Odisha, 751024, India.

 

Mantu Meher
Kalinga Institute of Social Sciences Deemed to be University, Bhubaneswar, Odisha, 751024, India.

 

Priyoneel Basu
Department of Zoology, School of Biological Sciences, Doctor Harisingh Gour Vishwavidyalaya (A Central University), Sagar - 470003, Madhya Pradesh, India.

 

Sweta Arora

Kalinga Institute of Social Sciences Deemed to be University, Bhubaneswar, Odisha, 751024, India.

 

Please see the book here :- https://doi.org/10.9734/bpi/aodhr/v6/6234

Chronobiology: Unlocking the Mysteries of the Biological Clock | Book Publisher International

"Chronobiology: Unlocking the Mysteries of the Biological Clock" delves into the intricate workings of the biological clock, exploring its profound influence on various aspects of human physiology, behavior, and health. This comprehensive guide offers a multifaceted exploration of chronobiology, encompassing its historical roots, contemporary research findings, and practical applications. From elucidating the molecular mechanisms underlying circadian rhythms to examining the role of chronobiology in sleep disorders, mood regulation, and metabolic health, this book provides invaluable insights into the fundamental principles governing our internal timekeeping systems. Through a blend of scientific rigor and accessible language, readers will gain a deeper understanding of how our biological clocks shape our daily lives and impact overall well-being.

Author(s) Details:

Dr. Nayan K. Prasad,
Department of Zoology, RRM Campus, Tribhuvan University, Nepal.

Dr. Sanjeev Kumar,
Department of Zoology, B M College, Rahika, Lalit Narayan Mithila University, Darbhanga -846004, India.

Please see the link here: https://stm.bookpi.org/CUMBC/article/view/14293

Chronotherapeutic Drug Delivery System - A Detailed Study | Chapter 11 | Novel Aspects on Pharmaceutical Research Vol. 8

The study of during the day clocks and the natural platform's likely uses for them has managed to an increased interest in chronotherapy research. This area of research specifies important visions for improving current drug delivery science. Chronotherapy involves executing drugs in sync with circadian music to target particular sites in the body. Among them pulsatile drug transfer system gains recent consideration where the drug be necessary to deliver at desired scene with official time of region by offering multiple benefits for the sufferers. Recently, research has been attracted on chronotherapeutics for the disease such as asthma, arthritis, malignancy, diabetes, hypertension, hypercholesterlemia, congestive heart failure and stroke. They have been concocted according to the biological clock of the body to exhibit  complete release of drug after the particularized lag opportunity, especially for drugs that undergo first pass absorption by liver and drug requirement all the while nocturnal dosing. There have existed various attempts to cultivate a therapeutic system that gives drugs to treat rhythmic diseases established their occurrence. The ideal chronotherapeutic plan should release the drug rapidly and entirely after a distinguishing lag time. Researchers have directed on developing chronotherapeutic drug transfer systems using polymer films that are dependent on something erosion, slippery, or opposing as well as sonic cues systems for giving drugs. This chapter investigate the idea of chronotherapy, problems knowing in its progress, present methods, and potential uses in medication transmittal for treating disorders affiliated to circadian rhythm.

Author(s) Details:

D. Nagasamy Venkatesh,
Department of Pharmaceutics, JSS College of Pharmacy, Rocklands, Post Box No: 20, Ootacamund-643001, Tamil Nadu, India.

N. Arun,
Department of Pharmaceutics, JSS College of Pharmacy, Ootacamund, JSS Academy of Higher Education & Research, Mysuru-643 001, India.

S. D. Shanmugakumar,
Jyothishmathi Institute of Pharmaceutical Sciences Thimmapur, Karimnagar, Telanagana-505481, India.

Please see the link here: https://stm.bookpi.org/NAPR-V8/article/view/11658