This study was undertaken to assess stress hormones response after awake videoassisted thoracoscopic surgery (VATS). Plasma levels of adrenal-corticotropic hormone (ACTH), cortisol, epinephrine, norepinephrine, and glucose were assessed at baseline, 3 h postoperatively (T1), and on postoperative mornings 2 (T2) and 3 (T3) in 21 patients undergoing awake VATS with epidural anesthesia for non-malignant conditions (n=11) or equivalent procedures performed with general anesthesia. Epinephrine level peaked in both groups at T1, although significant change from baseline values occurred in the control group only [median-Delta: 6 ng/l (IQR: 4-6), P=0.005]. Cortisol level was lower in the study group at T1 (15.5 microg/dl vs. 23.0 microg/dl, P=0.001) and T2 (15.2 microg/dl vs. 19.2 microg/dl, P=0.002). In the control group, peak cortisol level proved not to be related to changes in ACTH (R=0.23, P=0.46). At T2, glucose (137 mg/dl vs. 98 mg/dl, P=0.01) and C-reactive protein (P=0.04) were higher in the control group. No other clinically relevant between-groups differences were found in aspecific acute-response factors. Overall, these preliminary findings suggest attenuated stress response after awake VATS in comparison with equivalent procedure performed under general anesthesia and one-lung ventilation.

Tacconi, F., Pompeo, E., Sellitri, F., Mineo, T.c. (2010). Surgical stress hormones response is reduced after awake videothoracoscopy. INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY, 10(5), 666-671 [10.1510/icvts.2009.224139].

Surgical stress hormones response is reduced after awake videothoracoscopy

TACCONI, FEDERICO;POMPEO, EUGENIO;SELLITRI, FRANCESCO;MINEO, TOMMASO CLAUDIO
2010-05-01

Abstract

This study was undertaken to assess stress hormones response after awake videoassisted thoracoscopic surgery (VATS). Plasma levels of adrenal-corticotropic hormone (ACTH), cortisol, epinephrine, norepinephrine, and glucose were assessed at baseline, 3 h postoperatively (T1), and on postoperative mornings 2 (T2) and 3 (T3) in 21 patients undergoing awake VATS with epidural anesthesia for non-malignant conditions (n=11) or equivalent procedures performed with general anesthesia. Epinephrine level peaked in both groups at T1, although significant change from baseline values occurred in the control group only [median-Delta: 6 ng/l (IQR: 4-6), P=0.005]. Cortisol level was lower in the study group at T1 (15.5 microg/dl vs. 23.0 microg/dl, P=0.001) and T2 (15.2 microg/dl vs. 19.2 microg/dl, P=0.002). In the control group, peak cortisol level proved not to be related to changes in ACTH (R=0.23, P=0.46). At T2, glucose (137 mg/dl vs. 98 mg/dl, P=0.01) and C-reactive protein (P=0.04) were higher in the control group. No other clinically relevant between-groups differences were found in aspecific acute-response factors. Overall, these preliminary findings suggest attenuated stress response after awake VATS in comparison with equivalent procedure performed under general anesthesia and one-lung ventilation.
mag-2010
Pubblicato
Rilevanza internazionale
Articolo
Sì, ma tipo non specificato
Settore MED/21 - CHIRURGIA TORACICA
English
Senza Impact Factor ISI
Hormones; Blood Glucose; Hydrocortisone; Middle Aged; Anesthesia, General; Statistics, Nonparametric; Cohort Studies; Adrenocorticotropic Hormone; Probability; Adult; Treatment Outcome; Male; Pilot Projects; Female; Anesthesia, Epidural; Lung Diseases; Stress, Physiological; Norepinephrine; Epinephrine; Humans; Thoracic Surgery, Video-Assisted; Follow-Up Studies; Postoperative Period; Respiratory Function Tests; Biological Markers; Case-Control Studies
Tacconi, F., Pompeo, E., Sellitri, F., Mineo, T.c. (2010). Surgical stress hormones response is reduced after awake videothoracoscopy. INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY, 10(5), 666-671 [10.1510/icvts.2009.224139].
Tacconi, F; Pompeo, E; Sellitri, F; Mineo, Tc
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2108/10135
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