• Ahmet Kemalettin Koltka, Mehmet İlhan, Achmet Ali, Gök Ali Fuat Kaan AFK, Nükhet Sivrikoz, Teoman Hakan Yanar, Mustafa Kayıhan Günay, and Cemalettin Ertekin.
• Department of Anesthesiology, İstanbul University İstanbul Faculty of Medicine, İstanbul-Turkey. koltkak@yahoo.com.
• Ulus Travma Acil Cer. 2018 Jan 1; 24 (1): 20-24.

BackgroundFatigue and sleep deprivation can affect rational decision-making and motor skills, which can decrease medical performance and quality of patient care. The aim of the present study was to investigate the association between times of the day when laparoscopic general surgery under general anesthesia was performed and their adverse outcomes.MethodsAll laparoscopic cholecystectomies and appendectomies performed at the emergency surgery department of a tertiary university hospital from 01. 01. 2016 to 12. 31. 2016 were included. Operation times were divided into three groups: 08.01-17.00 (G1: daytime), 17.01-23.00 (G2: early after-hours), and 23.01-08.00 (G3: nighttime). The files of the included patients were evaluated for intraoperative and postoperative surgery and anesthesia-related complications.ResultsWe used multiple regression analyses of variance with the occurrence of intraoperative complications as a dependent variable and comorbidities, age, gender, body mass index (BMI), ASA score, and operation time group as independent variables. This revealed that nighttime operation (p<0.001; OR, 6.7; CI, 2.6-16.9) and older age (p=0.004; OR, 1.04; CI, 1.01-1.08) were the risk factor for intraoperative complications. The same analysis was performed for determining a risk factor for postoperative complications, and none of the dependent variables were found to be associated with the occurrence of postoperative complications.ConclusionNighttime surgery and older patient age increased the risk of intraoperative complications without serious morbidity or mortality, but no association was observed between the independent variables and the occurrence of postoperative complications.

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