Evaluation of stress-related hormones after surgery.
BACKGROUND
Improvements in instrumentation, optics, video cameras and technology have brought laparoscopy to the point at which many surgical procedures that once could be performed only by laparotomy are now successfully performed endoscopically.


METHODS
Twenty women undergoing surgery by laparotomy (11 patients) or laparoscopy (9 patients) were evaluated prospectively. Concentrations of adrenaline, noradrenaline, cortisol, prolactin, and ACTH were measured. Statistical analysis was performed by using the Friedman Two-way ANOVA, Kruskal-Wallis 1-way ANOVA and Mann-Whitney U-Wilcoxon Rank Sum W Test.


RESULTS
By comparing the means of all serum levels of ACTH, cortisol and prolactin between the laparoscopy and the laparotomy group, significant differences of ACTH (p < 0.0001), prolactin (p = 0.0164) and cortisol (p < 0.0001) were found. Furthermore, statistically significant differences (p < 0.05) of the serum levels of noradrenaline and adrenaline between the laparoscopy and the laparotomy group were observed.


CONCLUSIONS
While laparoscopic surgery causes less activation of stress-related hormones laparotomy results in a much more obvious response to all hormones evaluated, particularly catecholamine and ACTH production. This is probably related to the major tissue trauma.
Friedrich
M
M
Department of Obstetrics and Gynecology, University of the Saarland, Homburg, Germany.
Rixecker
D
D
Friedrich
G
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D000324:Adrenocorticotropic Hormone / Q000097:blood; D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage; D001794:Blood Pressure; D004837:Epinephrine / Q000097:blood; D005260:Female; D006728:Hormones / Q000097:blood*; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D010535:Laparoscopy / Q000009:adverse effects*; D007813:Laparotomy / Q000009:adverse effects*; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage; D009638:Norepinephrine / Q000097:blood; D010147:Pain Measurement; D011388:Prolactin / Q000097:blood; D011446:Prospective Studies; D013312:Stress, Physiological / Q000097:blood* / Q000209:etiology; D013997:Time Factors
D000701:Analgesics, Opioid; D006728:Hormones; D009020:Morphine; D000324:Adrenocorticotropic Hormone; D011388:Prolactin; D006854:Hydrocortisone; D009638:Norepinephrine; D004837:Epinephrine