Surgical Stress and Neuroendocrine Responses in Infants and Children

Surgical Stress and Neuroendocrine Responses in Infants and Children INTRODUCTION We studied the stress hormone response to surgery in 42 infants and children. Plasma levels of the stress hormones ACTH, Cortisol, betaendorphin and arginine-vasopressin (AVP) were determined on three occasions, i.e., one day before surgery, 60 to 90 minutes after skin closure and on the day after surgery (anesthesia by halothane and nitrous oxide). We observed an increase in the levels of both ACTH and Cortisol in most patients after surgery, although there was no correlation between them. Betaendorphin levels, on the other hand, rose after surgery and correlated significantly with ACTH in 30 patients. A steep rise in AVP levels was found in 84% of the subjects, a phenomenon that could not have been due only to osmotic or cardiovascular stimuli. The values of all the stress hormones declined and normalized on the day after surgery. We conclude that routine surgery in infancy or childhood induces a dramatic, albeit transient, stimulation of neuroendocrine stress hormones. KEY WORDS ACTH, AVP, beta-endorphin, Cortisol, surgical stress, infants Several studies on adult patients have provided evidence that pain, trauma or surgery leads to hypersecretion of the stress hormones Cortisol, growth hormone /1,2/, ACTH 13-61, beta-endorphin /7,8/ and arginine-vasopressin (AVP) /9-12/ http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Pediatric Endocrinology and Metabolism de Gruyter

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Publisher
de Gruyter
Copyright
Copyright © 1995 by the
ISSN
0334-018X
eISSN
2191-0251
DOI
10.1515/JPEM.1995.8.3.187
Publisher site
See Article on Publisher Site

Abstract

INTRODUCTION We studied the stress hormone response to surgery in 42 infants and children. Plasma levels of the stress hormones ACTH, Cortisol, betaendorphin and arginine-vasopressin (AVP) were determined on three occasions, i.e., one day before surgery, 60 to 90 minutes after skin closure and on the day after surgery (anesthesia by halothane and nitrous oxide). We observed an increase in the levels of both ACTH and Cortisol in most patients after surgery, although there was no correlation between them. Betaendorphin levels, on the other hand, rose after surgery and correlated significantly with ACTH in 30 patients. A steep rise in AVP levels was found in 84% of the subjects, a phenomenon that could not have been due only to osmotic or cardiovascular stimuli. The values of all the stress hormones declined and normalized on the day after surgery. We conclude that routine surgery in infancy or childhood induces a dramatic, albeit transient, stimulation of neuroendocrine stress hormones. KEY WORDS ACTH, AVP, beta-endorphin, Cortisol, surgical stress, infants Several studies on adult patients have provided evidence that pain, trauma or surgery leads to hypersecretion of the stress hormones Cortisol, growth hormone /1,2/, ACTH 13-61, beta-endorphin /7,8/ and arginine-vasopressin (AVP) /9-12/

Journal

Journal of Pediatric Endocrinology and Metabolismde Gruyter

Published: Jul 1, 1995

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