Persistent endocrine stress response in patients undergoing cardiac surgery

Area of Science:

• Anesthesiology
• Endocrinology
• Surgical Stress Response

Background:

• Major surgeries like coronary artery bypass grafting (CABG) trigger significant endocrine stress responses.
• General anesthesia techniques aim to mitigate these physiological stress markers.

Purpose of the Study:

• To investigate the endocrine stress response in male patients undergoing elective CABG surgery.
• To evaluate the effectiveness of a balanced anesthesia technique using sufentanil, isoflurane, and midazolam on stress hormone levels up to postoperative day two.

Main Methods:

• Blood samples were collected from 68 male patients undergoing CABG surgery.
• Levels of cortisol, epinephrine, norepinephrine, prolactin, and growth hormone were measured preoperatively and postoperatively.
• Anesthesia involved a balanced technique with sufentanil, isoflurane, and midazolam.

Main Results:

• Intraoperative stress hormone levels did not significantly increase during extracorporeal circulation.
• Postoperative evening levels of cortisol, epinephrine, norepinephrine, and growth hormone were significantly elevated.
• Cortisol, growth hormone, and norepinephrine remained elevated up to the second postoperative day.

Conclusions:

• The balanced anesthesia technique effectively prevented intraoperative endocrine stress response during CABG surgery.
• The primary endocrine stress response begins in the early postoperative period, particularly in the intensive care unit.
• A sustained stress response, indicated by elevated cortisol, growth hormone, and norepinephrine, persists for over two days post-surgery.