Related Experiment Videos
Hormonal responses to surgical stress in children
1Department of Pediatrics, Harvard Medical School, Massachusetts General Hospital, Boston.
Insights
Children exhibit significant hormonal stress responses to surgery, with increased prolactin and cortisol levels post-operation. These responses are consistent across different ages and surgical factors, though females show a greater prolactin increase.
Area of Science:
- Pediatric Endocrinology
- Surgical Stress Response
Background:
- Hormonal responses to surgical stress are understood in adults.
- The specific stress responses in children undergoing surgery require further investigation.
Purpose of the Study:
- To investigate age-related differences in hormonal stress responses to surgery in children.
- To compare prolactin and cortisol levels before and after elective surgery in pediatric patients.
Main Methods:
- Prospective study of 98 children (2-20 years) undergoing elective surgery.
- Measurement of serum prolactin and cortisol concentrations preoperatively and 1 hour postoperatively.
- Stratification of data by patient age, anesthetic technique, and operation length.
Main Results:
- All patients showed significant increases in serum cortisol and prolactin postoperatively (P < .05).
- No significant differences in hormonal responses were found based on age, anesthetic technique, or operation length.
- Females exhibited significantly higher postoperative serum prolactin concentrations compared to males (P < .05).
Conclusions:
- Children demonstrate significant increases in circulating prolactin and cortisol following surgery and anesthesia.
- Age, surgery duration, and anesthetic technique do not significantly affect these hormonal responses in children.
- Female children show a more pronounced prolactin response to surgical stress than male children.
Abstract:
The hormonal responses to surgical stress in adults are well characterized. We hypothesized that children have age-related differences in the "stress responses" to surgery. To test this hypothesis we prospectively studied 98 children (aged 2 to 20 years) undergoing elective surgical procedures under general anesthesia. Preoperative and postoperative (1 hour postoperation) blood samples were obtained and serum prolactin and cortisol concentrations were measured. Patient data were stratified by patient age and length of operation. All patients had significant (P < .05) increases in serum cortisol and prolactin concentrations 1 hour postoperatively as compared with preoperative values. However, there were no significant differences in prolactin and cortisol responses to surgery based on the age, anesthetic technique, or length of operation. Females had higher mean (+/- SD) serum prolactin concentrations (78.41 +/- 62.23 micrograms/L) as compared with males postoperatively (39.8 +/- 21.75 micrograms/L) (P < .05). We conclude the following: (1) children have significant increases in circulating prolactin and cortisol concentrations following surgery and anesthesia, and that those increases are not affected by age, length of surgery, or anesthetic technique; and (2) females have greater prolactin responses to surgery and anesthesia than males.