Zirkadiane Medizin – wie relevant in der Anästhesiologie?

Das zirkadiane System, auch als innere Uhr bezeichnet, spielt eine wesentliche Rolle in der Regulierung physiologischer Prozesse. Dieses System beeinflusst den Schlaf-wach-Zyklus, die Hormonsekretion, den Stoffwechsel, das Immunsystem und kognitive Funktionen. Diese Übersicht fasst aktuelle Erkenntnisse zu den Wirkungen der Anästhesie auf zirkadianen Rhythmen zusammen und beleuchtet mögliche Mechanismen und klinische Implikationen.

Abstract

The circadian system, also known as the internal clock, plays an essential role in regulating physiological processes that are adapted to the 24-hour day-night cycle. This system modulates sleep-wake cycles, hormone secretion, metabolism, immune and cognitive functions, among other processes. In anesthesiology, we use hypnotics to strongly influence consciousness, sleep architecture, and the nervous system. It is therefore assumed that anesthesia and sedation may also influence circadian rhythms, as patients often report sleep disturbances and other cognitive and emotional impairments after anesthesiological procedures and surgeries. This overview summarizes current findings on the effects of anesthesia on circadian rhythms and highlights possible mechanisms and clinical implications.

Kernaussagen

• Zirkadiane Störungen durch Anästhesie: Eine Allgemeinanästhesie kann zirkadiane Rhythmen erheblich stören, was zu Schlafproblemen und möglicherweise zu einer beeinträchtigten Genesung der Patient*innen führt. Ein besseres Verständnis der Mechanismen dieser Effekte – sowohl der Einfluss der Anästhesie auf die innere Uhr als auch umgekehrt – ist entscheidend.

• Unterschiede zwischen Anästhetika: Verschiedene Anästhetika haben unterschiedliche Effekte auf die zirkadiane Uhr. Beispielsweise können GABA- und NMDA-beeinflussende Anästhetika wie Propofol und Ketamin Phasenverschiebungen in der inneren Uhr hervorrufen.

• Tageszeit der Operation: Operationen, die tagsüber durchgeführt werden, verursachen wahrscheinlich stärkere Phasenverschiebungen als nächtliche Eingriffe.

• Dauer der Anästhesie: Kürzere Eingriffe mit weniger Anästhesiezeit wirken sich tendenziell weniger stark auf die zirkadiane Uhr aus.

• Strategien zur Reduzierung zirkadianer Störungen: Die Planung der Eingriffszeiten, die Auswahl geeigneter Anästhetika sowie möglicherweise unterstützende Maßnahmen wie Lichttherapie könnten helfen, anästhesieinduzierte Störungen des zirkadianen Rhythmus zu mildern und so die Genesung der Patient*innen zu fördern.

Schlüsselwörter

zirkadianer Rhythmus - Anästhesie - Tag-Nacht-Rhythmus - Frühmobilisierung - Ernährung - Clock Genes

Keywords

circadian rhythm - anesthesia - day-night rhythm - early mobilization - nutrition - clock genes

Publication History

Article published online:
28 October 2025

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