title: Preoperative glucocorticoid administration attenuates the systemic stress response and hyperglycemia after surgical trauma in the rat.
abstract: The stress response to surgery is characterized by activation of the hypothalamic-pituitary-adrenal axis and the sympathetic nervous system, and by an inflammatory response and hyperglycemia. The aim of the present study was to investigate if preoperative corticosterone could reduce the postoperative systemic stress response, without aggravating hyperglycemia or interfering with activation of the hypothalamic-pituitary-adrenal axis, in a standardized rat model of surgical trauma. We used a standardized experimental model of intestinal resection in the rat. Exogenous corticosterone (8 mg/kg body weight) or vehicle was administered 2 hours before surgery; and postoperative plasma concentrations of interleukin-6, interleukin-10, adrenaline, noradrenaline, glucose, and insulin were determined. Exogenous corticosterone decreased preoperative plasma adrenaline but did not change plasma glucose or insulin levels. Moreover, corticosterone reduced postoperative plasma interleukin-6, catecholamines, and glucose (all P < .001-.05) without any effect on the plasma corticosterone concentration compared with vehicle-treated controls. A preoperative 2-hour exposure of physiologic poststress corticosterone concentrations not only suppressed plasma IL-6 levels but also inhibited surgery-induced adrenaline release and suppressed plasma glucose levels. We hypothesize that glucocorticoids attenuated the inflammatory response in injured tissues that reduced afferent input into brain areas regulating the neuroendocrine response.
authors.affiliation: Division of Surgery, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet at Karolinska University Hospital Huddinge, 14186 Stockholm, Sweden. peter.hager@ki.se
authors.forename: Peter
authors.initials: P
authors.lastname: Hager
authors.forename: Johan
authors.initials: J
authors.lastname: Permert
authors.forename: Ann-Charlotte
authors.initials: AC
authors.lastname: Wikström
authors.forename: Margery K
authors.initials: MK
authors.lastname: Herrington
authors.forename: Claes-Göran
authors.initials: CG
authors.lastname: Ostenson
authors.forename: Lisa
authors.initials: L
authors.lastname: Strömmer
mesh_terms: D000818:Animals; D001786:Blood Glucose / Q000032:analysis; D004837:Epinephrine / Q000097:blood; D005938:Glucocorticoids / Q000008:administration & dosage*; D006854:Hydrocortisone / Q000097:blood; D006943:Hyperglycemia / Q000517:prevention & control*; D007328:Insulin / Q000097:blood; D016753:Interleukin-10 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D009638:Norepinephrine / Q000097:blood; D051381:Rats; D017208:Rats, Wistar; D013514:Surgical Procedures, Operative / Q000009:adverse effects*; D018746:Systemic Inflammatory Response Syndrome / Q000517:prevention & control*
chemical_list: D001786:Blood Glucose; D005938:Glucocorticoids; D007328:Insulin; D015850:Interleukin-6; D016753:Interleukin-10; D006854:Hydrocortisone; D009638:Norepinephrine; D004837:Epinephrine