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Hormonal response to surgical stress in schoolchildren

J Castejón-Casado1, M Moreno-Prieto, J C Valladares-Mendías

  • 1Department of Paediatric Surgery, Virgen de las Nieves University Hospital, Granada, Spain.

European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery ... [Et Al] = Zeitschrift Fur Kinderchirurgie
|May 24, 2001
PubMed

Insights

Pediatric surgical stress elevates adrenocorticotropic hormone (ACTH), cortisol, and beta-endorphin post-surgery. High stress and emergency procedures significantly impact these hormone levels, with beta-endorphin remaining elevated longer.

Area of Science:

  • Pediatric Endocrinology
  • Surgical Stress Response
  • Hormonal Monitoring in Children

Background:

  • Surgical procedures induce physiological stress responses in children.
  • Hormonal changes, including ACTH, cortisol, and beta-endorphin, are key indicators of this stress.
  • Understanding these hormonal dynamics is crucial for managing pediatric surgical patients.

Purpose of the Study:

  • To quantify ACTH, cortisol, and beta-endorphin levels in children before and after surgery.
  • To investigate correlations between hormonal fluctuations and surgical stress severity.
  • To assess the impact of elective versus emergency surgery on these hormonal responses.

Main Methods:

  • Prospective cohort study of 78 children (ages 6-13).
  • Plasma hormone concentrations (ACTH, cortisol, beta-endorphin) measured preoperatively and at 1 and 24 hours postoperatively.
  • Surgical stress categorized as low or high using the Oxford scale; statistical analysis included t-tests and Pearson's correlation.

Main Results:

  • Hormone levels significantly increased one hour post-surgery.
  • ACTH and cortisol normalized by 24 hours, while beta-endorphin remained elevated.
  • High surgical stress correlated with increased cortisol (1 hr) and beta-endorphin (24 hrs).
  • Emergency surgery patients exhibited higher baseline and postoperative ACTH and cortisol.

Conclusions:

  • Pediatric surgical response involves elevated ACTH, cortisol, and beta-endorphin one hour post-op, with prolonged beta-endorphin increase.
  • Cortisol serves as a reliable marker for surgical stress intensity.
  • Emergency surgery is linked to significantly higher ACTH and cortisol levels.
Abstract

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