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Related Experiment Videos

Hormone response in gynecologic surgery.

O Viinamäki, J Kanto, M Grönroos

    International Journal of Clinical Pharmacology, Therapy, and Toxicology
    |July 1, 1983
    PubMed
    Summary

    Acetated Ringer's lactate without glucose led to a more physiological response in gynecologic surgery patients compared to fluids with glucose. This suggests reduced surgical stress and hormonal changes when glucose is omitted.

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    Area of Science:

    • Anesthesiology
    • Endocrinology
    • Gynecologic Surgery

    Background:

    • Fluid management during gynecologic surgery impacts patient physiology.
    • The choice of intravenous fluids, particularly glucose-containing solutions, may influence hormonal stress responses.

    Purpose of the Study:

    • To compare the effects of acetated Ringer's lactate with and without glucose on hormonal and metabolic markers during gynecologic surgery.
    • To investigate the role of surgical trauma and anesthetic agents versus fluid composition in stress responses.

    Main Methods:

    • Plasma arginine vasopressin (AVP), plasma renin activity (PRA), human growth hormone (HGH), immunoreactive insulin (IRI), and blood glucose were measured in 25 gynecologic inpatients.
    • Patients were divided into three groups: dilatation and curettage, hysterectomy with glucose-free lactate, and hysterectomy with 5% glucose lactate.
    • Measurements were taken preoperatively, intraoperatively, and postoperatively.

    Main Results:

    • Plasma AVP increased in groups receiving glucose-containing fluids and those undergoing hysterectomy, suggesting a stress response.
    • Human growth hormone (HGH) increased significantly in the hysterectomy group with glucose, while blood glucose and insulin levels rose markedly.
    • Plasma renin activity (PRA) showed no significant changes across all groups.

    Conclusions:

    • Greater surgical trauma, rather than anesthetic depth, likely contributed to increased AVP secretion in more invasive procedures.
    • Acetated Ringer's lactate without glucose appears to elicit a more physiological response during gynecologic surgery compared to solutions containing glucose.
    • Fluid management strategies should consider the omission of glucose to potentially mitigate stress responses in gynecologic surgery.

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