Document Detail


Surgical stress hormones response is reduced after awake videothoracoscopy.
MedLine Citation:
PMID:  20179134     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This study was undertaken to assess stress hormones response after awake videoassisted thoracoscopic surgery (VATS). Plasma levels of adrenal-corticotropic hormone (ACTH), cortisol, epinephrine, norepinephrine, and glucose were assessed at baseline, 3 h postoperatively (T1), and on postoperative mornings 2 (T2) and 3 (T3) in 21 patients undergoing awake VATS with epidural anesthesia for non-malignant conditions (n=11) or equivalent procedures performed with general anesthesia. Epinephrine level peaked in both groups at T1, although significant change from baseline values occurred in the control group only [median-Delta: 6 ng/l (IQR: 4-6), P=0.005]. Cortisol level was lower in the study group at T1 (15.5 microg/dl vs. 23.0 microg/dl, P=0.001) and T2 (15.2 microg/dl vs. 19.2 microg/dl, P=0.002). In the control group, peak cortisol level proved not to be related to changes in ACTH (R=0.23, P=0.46). At T2, glucose (137 mg/dl vs. 98 mg/dl, P=0.01) and C-reactive protein (P=0.04) were higher in the control group. No other clinically relevant between-groups differences were found in aspecific acute-response factors. Overall, these preliminary findings suggest attenuated stress response after awake VATS in comparison with equivalent procedure performed under general anesthesia and one-lung ventilation.
Authors:
Federico Tacconi; Eugenio Pompeo; Francesco Sellitri; Tommaso C Mineo
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2010-02-23
Journal Detail:
Title:  Interactive cardiovascular and thoracic surgery     Volume:  10     ISSN:  1569-9285     ISO Abbreviation:  Interact Cardiovasc Thorac Surg     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-04-20     Completed Date:  2010-08-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101158399     Medline TA:  Interact Cardiovasc Thorac Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  666-71     Citation Subset:  IM    
Copyright Information:
2010 Published by European Association for Cardio-Thoracic Surgery. All rights reserved.
Affiliation:
Division of Thoracic Surgery, Fondazione Policlinico Tor Vergata, Tor Vergata University School of Thoracic Surgery, Rome, Italy. tacconifederico@libero.it
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MeSH Terms
Descriptor/Qualifier:
Adrenocorticotropic Hormone / blood
Adult
Anesthesia, Epidural / adverse effects,  methods*
Anesthesia, General / adverse effects,  methods*
Biological Markers / blood
Blood Glucose / analysis
Case-Control Studies
Cohort Studies
Epinephrine / blood
Female
Follow-Up Studies
Hormones / blood*
Humans
Hydrocortisone / blood
Lung Diseases / pathology,  surgery*
Male
Middle Aged
Norepinephrine / blood
Pilot Projects
Postoperative Period
Probability
Respiratory Function Tests
Statistics, Nonparametric
Stress, Physiological*
Thoracic Surgery, Video-Assisted / adverse effects,  methods*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Blood Glucose; 0/Hormones; 50-23-7/Hydrocortisone; 51-41-2/Norepinephrine; 51-43-4/Epinephrine; 9002-60-2/Adrenocorticotropic Hormone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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