What question did this study set out to answer?

To characterize the neuroendocrine, sympathetic, and renin-angiotensin system responses to controlled surgical incision, maintenance anesthesia, and anesthetic emergence.

May 1, 1987The Journal of Clinical Endocrinology & Metabolism

Responses of the Hypothalamic-Pituitary-Adrenal and Renin-Angiotensin Axes and the Sympathetic System During Controlled Surgical and Anesthetic Stress

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Authors

RURobert UdelsmanMiami Heart Research Institute JNJeffrey A. NortonUnited States Department of Health and Human Services SJSANDRA E. JELENICHNational Institutes of Health

Discussion

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Implication

Clinical study reveals that anesthesia emergence drives peak stress hormone release in surgical patients, indicating recovery rather than surgical trauma provokes the primary endocrine surge.

Key Points

To characterize the neuroendocrine, sympathetic, and renin-angiotensin system responses to controlled surgical incision, maintenance anesthesia, and anesthetic emergence.
Evaluated 11 patients undergoing elective parathyroid or thyroid surgery under standardized preoperative sedation and isoflurane anesthesia.
Measured serial plasma concentrations of CRH, ACTH, cortisol, norepinephrine, epinephrine, and plasma renin activity across baseline, intraoperative, extubation, and postoperative stages.
During surgical exploration, plasma CRH (10 ± 2 pg/mL), ACTH (11.5 ± 1.4 pg/mL), cortisol (24 ± 4 µg/dL), and epinephrine (35 ± 10 pg/mL) remained within baseline ranges, accompanied by continuous rather than pulsatile ACTH release.
Anesthesia reversal and endotracheal extubation induced marked peak elevations in plasma ACTH (173 ± 45 pg/mL), cortisol (35 ± 6 µg/dL), and epinephrine (220 ± 56 pg/mL), while norepinephrine and plasma renin activity returned to basal levels.
All measured endocrine markers returned to normal basal physiological concentrations by the first postoperative day.

Cite This Study

Udelsman et al. (1987) studied this question.

synapsesocial.com/papers/6a1d1bf0ba65f5ee325dcf9d https://doi.org/10.1210/jcem-64-5-986

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Implication

Clinical study reveals that anesthesia emergence drives peak stress hormone release in surgical patients, indicating recovery rather than surgical trauma provokes the primary endocrine surge.

Responses of the Hypothalamic-Pituitary-Adrenal and Renin-Angiotensin Axes and the Sympathetic System During Controlled Surgical and Anesthetic Stress

Discussion

Member takes

Implication

Key Points

Cite This Study

Responses of the Hypothalamic-Pituitary-Adrenal and Renin-Angiotensin Axes and the Sympathetic System During Controlled Surgical and Anesthetic Stress

Discussion

Member takes

Implication

Key Points

Cite This Study

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