Salivary kallikrein output during the stress response to surgery

Sixteen adult humans (American Surgical Association, grade I-II) scheduled for elective hysterectomy and (or) oophorectomy with general anesthesia for benign disease were the subjects in this study of the output of kallikrein into the saliva during the stress response to surgery. Saliva samples for salivary kallikrein output determination and plasma for cortisol estimates were collected before and at several times after surgery. Subjective reports of pain were also recorded. Salivary kallikrein output was significantly elevated over preoperative levels at 2, 4, and 6 h following surgery and reached a level at 4 h that was 8 times higher than preoperative levels. All subjects experienced a stress response, as indicated by elevated levels of plasma cortisol, and all reported postoperative pain. The results indicate that increased salivary kallikrein output is associated with the stress response to surgery.