[Surgical stress and hypophyseal-adrenal activation in childhood].
BACKGROUND
The study on the physiological alterations due to surgical aggression (surgical stress), widely investigated in adults, is less known in paediatric age.


OBJECTIVE
Of this work is to quantify surgical stress (evaluated by means of Oxford Scale as high or low depending on its value bigger or lower than 6), after determining changes of plasmatic concentrations of ACTH, beta-endorphin and cortisol in operated children.


METHODS
Observational analytic design of a prospective cohort with internal comparison of the groups.


METHODS
33 (age 10 +/- 2.6 years; range 5 to 14 years).


METHODS
plasmatic concentrations of ACTH, beta-endorphin and cortisol determined before and after the intervention (1 and 24 hours after surgery), by radio-immune-analysis.


RESULTS
Significative increase of the three considered hormones one hour after surgery, with decrease of them until preoperative levels 24 hours later. Significative correlation between beta-endorphin (24 hours after surgery), cortisol (1 hour after surgery) and surgical stress levels.


CONCLUSIONS
Surgery in children provokes the activation of hipophysal-suprarrenal system. These levels early came back to normal ones, 24 hours after surgery. There is a specific change in beta-endorphin, that is why it is possible to assure that beta-endorphin is a "stress-hormone", since it is affected by surgical aggression. Cortisol seems to be a good index of level of surgical stress.
Valladares Mendías
J C
JC
Servicio de Cirugía Pediátrica, Hospital Universitario Virgen de las Nieves, Granada.
Alaminos Mingorance
M
M
Castejón Casado
J
J
Moreno Prieto
M
M
Ramírez Navarro
A
A
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D010913:Pituitary-Adrenal System / Q000503:physiopathology*; D011446:Prospective Studies; D013312:Stress, Physiological / Q000209:etiology* / Q000503:physiopathology*; D013514:Surgical Procedures, Operative / Q000009:adverse effects*