Perioperative Cortisol Release in Patients Who Underwent Carotid Endaarterektomy. the Impact of Anesthetic Modality
2011
Аутори:
Terzić, MilicaIgnjatović, Svetlana
Dajak, Marijana
Marković, Dejan
Ajdžanović, Vladimir
Milošević, Verica
Majkić-Singh, Nada
Тип документа:
Конференцијски прилог (Објављена верзија)
,
© 2011 Walter de Gruyter
Метаподаци
Приказ свих података о документуАпстракт:
Background. Surgical trauma cause a necessary biological response known as hyper metabolic stress response. Our aim was to determinate the degree of surgical trauma caused by carotid endaarterektomy (CEA) by evaluating the levels of plasma cortisol, and to define differences related to the use of lokoregional (LA) or general anesthesia (GA). Methods. We prospectively studied twenty consecutive CEA performed patients admitted at Clinic for Vascular Surgery. Patients were stratified for demographics and risk factors and operated under LA or GA depending on both the surgeon preference and patients compliance. Marker of stress response, serum cortisol, was measured preoperatively (before premedication), intraoperatively (before and after carotid artery cross clamping (CACC), and postoperatively (after admitting in postoperative care unit, 6 and 24 hours after surgery). Statistics were run by means of nonparametric ANOVA tests. Results. CEA was performed under GA in eight patients (40%), and under LA in twelve patients (60%). The two groups were comparable in terms of demographics and risk factors. Intraoperatively serum cortisol levels were higher (p<0.01) in the LA group for 29.5% in comparison to the GA group. Carotid artery cross clamping increased intraoperative cortisol levels in both GA and LA groups by 22.0% and 92.4% respectively, compared to the level before anesthesia application. Conclusions. The stress response to CEA regardless of the type of anesthesia was abolished within 24 hours after operation. Intraoperative stress response, namely hypercortisolemia directly correlated with sub clinical and clinical cerebral hypo perfusion during CACC.
Финансирање / пројекти:
- Одговор неуроендокриног система пацова на одабране биљне екстракте, фитоестрогене, стероидне и пептидне хормоне (RS-MESTD-Basic Research (BR or ON)-173009)
У:
- 21st International Congress of Clinical Chemistry and Laboratory Medicine: IFCC-WORLDLAB; 2011 May 15-19; Berlin, Germany. Clinical Chemistry and Laboratory Medicine. Berlin: Walter de Gruyter; 2011. p. S284. (Clinical Chemistry and Laboratory Medicine; Vol. 49; Spec Suppl).