Key result
Anesthetic drugs variably inhibit ACTH-stimulated cortisol production but poorly affect prolactin release, both of which contribute to memory consolidation during general anesthesia.
This review highlights the interaction between surgical stress-induced hormonal changes (cortisol and prolactin) and memory consolidation during general anesthesia.
Should not yet alter anesthetic selection; hypothesis-generating for hormonal modulation of awareness.
The stress response to surgery includes a number of hormonal changes initiated by neuronal activation of the Hypothalamo-Pituitary-Adrenal (HPA) axis. Surgery is one of the most potent activators of ACTH and cortisol secretion, and increased plasma concentrations of both hormones can be measured few minutes after the start of surgery. A variable inhibition of ACTH-stimulated production of cortisol by anesthetic drugs has been demonstrated in clinical studies. Endocrine response to stress also includes a release of pituitary hormone prolactin which is poorly affected by anesthesia. These two hormones seem to mostly contribute to memory consolidation processes during anesthesia. This review summarizes the main aspects of interaction between stress response to surgery and cognition during general anesthesia.
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Aceto Paola Lai Carlo (2015) conducted a review in Stress response to surgery and cognition. Anesthetic drugs was evaluated. Anesthetic drugs variably inhibit ACTH-stimulated cortisol production but poorly affect prolactin release, both of which contribute to memory consolidation during general anesthesia.
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