title: Perioperative thyroid hormone kinetics in patients undergoing major oral and maxillofacial operations.
abstract: OBJECTIVE
  The aim of this study was to investigate the perioperative response of serum thyroid hormones in patients who underwent extensive maxillofacial operations with desflurane (0.2 to 1.5 MAC) and remifentanil (0.05 to 0.3 microg/kg/min) anesthesia.
  
  
  METHODS
  Serum thyroxine, total and free triiodothyronine, thyroid-stimulating hormone, interleukin-1beta and 6, TNF-alpha, free fatty acids, S100B protein, CRP, as well as amyloid A protein were measured in 13 patients subjected to extensive oral and maxillofacial operations. Samples were collected before anesthesia induction, at the end, and 6, 12, 24, and 72 hours after the end of surgery. Patients during the study fasted, and at the postoperative period received Ringer's saline or with 5% dextrose alternatively, at the rate of 0.5 to 1.5 mL/kg/hr.
  
  
  RESULTS
  Thyroid hormones concentrations showed a significant decrease over time whereas their values recovered to the baseline 72 hours after surgery. Interleukin 1beta, 6, S100B protein, CRP, serum amyloid A protein, and free fatty acids showed a significant increase 6, 12, and 24 hours after the end of the operation as related to the basal value. No significant clinical complications were recorded over the study.
  
  
  CONCLUSIONS
  Patients undergoing extensive oral and maxillofacial surgery exhibit marked decrease in serum thyroid hormones. Stress response, anesthesia, and perioperative fasting may be decisive factors eliciting this response. These metabolic derangements do not deteriorate the clinical outcome and subsequently may be an adaptive response for energy preservation in various organs.
authors.affiliation: Department of Pharmacology, University of Athens, and Department of Anaesthesiology, General Hospital of Athens, Greece. saranteas@ath.forthnet.gr
authors.forename: Theodosios
authors.initials: T
authors.lastname: Saranteas
authors.forename: Annete
authors.initials: A
authors.lastname: Tachmintzis
authors.forename: Nikos
authors.initials: N
authors.lastname: Katsikeris
authors.forename: Eustathios
authors.initials: E
authors.lastname: Lykoudis
authors.forename: Iordanis
authors.initials: I
authors.lastname: Mourouzis
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Anteriotis
authors.forename: Chrisanthos
authors.initials: C
authors.lastname: Alexopoulos
authors.forename: Antonia
authors.initials: A
authors.lastname: Dimakopoulou
authors.forename: Vasilios
authors.initials: V
authors.lastname: Dimitriou
authors.forename: Costantinos
authors.initials: C
authors.lastname: Pantos
authors.forename: Christina
authors.initials: C
authors.lastname: Tesseromatis
mesh_terms: D000209:Acute-Phase Proteins / Q000032:analysis; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000766:Anesthesia, Dental / Q000379:methods; D016207:Cytokines / Q000097:blood; D003799:Dental Stress Analysis; D005215:Fasting / Q000097:blood; D005260:Female; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000502:physiology*; D007700:Kinetics; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D019647:Oral Surgical Procedures; D018709:Statistics, Nonparametric; D013312:Stress, Physiological / Q000097:blood*; D013961:Thyroid Gland / Q000502:physiology*; D013963:Thyroid Hormones / Q000097:blood*; D013972:Thyrotropin / Q000097:blood
chemical_list: D000209:Acute-Phase Proteins; D016207:Cytokines; D013963:Thyroid Hormones; D013972:Thyrotropin