Responses of Plasma Adrenocorticotropic Hormone, Cortisol, and Cytokines during and after Upper Abdominal Surgery

Naito, Yoshiyuki; Tamai, Sunao; Shingu, Koh; Shindo, Kazuo; Matsui, Teruo; Segawa, Hajime; Nakai, Yoshikatsu; Mori, Kenjiro

doi:10.1097/00000542-199209000-00004

Cited by 231 publications

(140 citation statements)

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“…This could be explained by the stress of surgery. Elevated levels of serum cortisol have been reported for up to 3 days after major abdominal surgery (21,22). Serum levels of PICP and PINP increased significantly in PHPT after PTX in the present study.…”

Section: Discussionsupporting

confidence: 66%

Immediate changes in biochemical markers of bone turnover and circulating interleukin-6 after parathyroidectomy for primary hyperparathyroidism

Guo

Holland²,

Jackson³

et al. 2000

European Journal of Endocrinology

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Objective: The time course of the immediate change in bone turnover after parathyroidectomy (PTX) for primary hyperparathyroidism (PHPT) is not clear. It is uncertain whether circulating interleukin-6 (IL-6) plays a role in mediating the acute withdrawal of the effects of parathyroid hormone (PTH) on bone turnover after PTX. The aims of this study were to determine the time course of immediate changes in biochemical markers of bone turnover after PTX and whether circulating IL-6 is involved in the immediate changes of bone turnover after PTX. Design and Methods: IL-6 and bone turnover markers were measured in eight women (aged 55 Ϯ 11 years, mean Ϯ S.D.) with PHTP at baseline and at 1-2 h, and 1, 2, 5, 7 and 12 days after PTX. We compared the results with those from eight individually matched women (healthy controls) and five subjects undergoing major surgery (surgical controls). Results: At baseline, serum levels of IL-6 and bone turnover markers were higher in PHPT than those in healthy controls (P<0.05). Serum levels of procollagen propeptides increased by 22 and 27% at days 2 and 5, respectively, compared with baseline (P < 0.05). Serum tartrate-resistant acid phosphatase decreased by 2 days after PTX, and urinary collagen crosslinks decreased significantly by 21-41% within 24 h (P<0.05). Serum IL-6 levels increased immediately in both PHPT and surgical controls at postoperative follow-up (repeated measures ANOVA). Conclusions: (1) PTX decreases bone resorption immediately and (2) circulating IL-6 is not involved in the changes in bone turnover immediately after PTX.

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Section: Discussionsupporting

confidence: 66%

Immediate changes in biochemical markers of bone turnover and circulating interleukin-6 after parathyroidectomy for primary hyperparathyroidism

Guo

Holland²,

Jackson³

et al. 2000

European Journal of Endocrinology

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“…All patients received regional anesthesia and analgesia (combined spinal epidural). Previous studies have reported marked suppression of inflammatory markers, including TNF-a and IL-6, with use of central neuraxial versus general anesthesia for THA [22].…”

Section: Discussionmentioning

confidence: 89%

“…Response of IL-6 to LPS induction on POD 1 was considered our primary outcome, as Naito et al [22] previously examined inflammatory markers after THA with epidural anesthesia and noted peak increases by POD 1 with return to baseline by POD 2. No data were available for an a priori power calculation.…”

Section: Sample Size Calculationmentioning

confidence: 99%

Association of Obesity With Inflammation and Pain After Total Hip Arthroplasty

Motaghedi

Bae

Memtsoudis

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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Background The prevalence of obesity is increasing, and obesity often leads to degenerative joint disease requiring total hip arthroplasty (THA). Obesity is a proinflammatory state associated with an increase in chronic, low-grade inflammatory response. As such, it may augment the postoperative inflammatory response, which has been associated with postoperative pain and complications.Questions/purposes We determined whether severity of obesity was associated with (1) severity of inflammatory response, as measured by the in vivo circulating levels of cytokines and ex vivo functional reactivity of mononuclear blood cells, and (2) severity of pain, as measured by verbal pain scores and analgesic consumption, in the first 24 hours after THA. Methods We studied 60 patients (20 normal weight, 20 overweight, 20 obese) undergoing elective primary unilateral THA in this prospective cross-sectional study. Blood samples were collected for C-reactive protein and cytokine levels, including IL-1b, IL-2, IL-6, IL-8, and tumor necrosis factor a (TNF-a), from patients before and 24 hours after surgery. Cytokine response of whole blood was evaluated ex vivo with or without two standard activators, phorbol-12-myristate-13-acetate and lipopolysaccharide, using standardized blood sample from patients at 24 hours. These standard immune activators are implicated in the inflammatory response to gram-negative infection, translocation of microbial products, pathophysiology of septic shock syndrome in human, and tumor promotion. Pain response was gauged using verbal pain scores (on a 0-to 10-point scale, where 0 = no pain and 10 = worst pain) at rest and with activity at 24 hours after surgery and analgesic

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“…Stress results in release of cytokines, and in particular the cytokine interleukin-1, which causes cortisol levels to rise thereby mobilising the body's glycogen and fat stores. 6 Control of cortisol release is modulated through the hypothalamic-pituitary-adrenal (HPA) axis, whereby secretion of corti-…”

Section: Physiology Of Glucocorticoidsmentioning

confidence: 99%

Steroid cover for dental patients on long-term steroid medication: proposed clinical guidelines based upon a critical review of the literature

Gibson

Ferguson

2004

Br Dent J

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Based to a great extent upon mainly anecdotal case reports and theory, there is a general acceptance that patients on longterm systemic steroid medication should receive supplementary glucocorticoids or 'steroid cover' when undergoing certain types of stressful treatment including dentistry. The theoretical basis to this practice is that exogenous steroids suppress adrenal function to an extent that insufficient levels of cortisol can be produced in response to stress, posing the risk of acute adrenal crisis with hypotension and collapse. The purpose of this paper is to review relevant literature and propose clinical guidelines for dental practitioners. Of numerous reported cases of adrenal crisis following procedural interventions, few stand up to critical evaluation. Other reviewers have reached similar conclusions. A number of studies confirm the low likelihood of significant adrenal insufficiency even following major surgical procedures. Various authors have suggested modified guidelines for management of patients on steroid medications. Patients on long-term steroid medication do not require supplementary 'steroid cover' for routine dentistry, including minor surgical procedures, under local anaesthesia. Patients undergoing general anaesthesia for surgical procedures may require supplementary steroids dependent upon the dose of steroid and duration of treatment.

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Responses of Plasma Adrenocorticotropic Hormone, Cortisol, and Cytokines during and after Upper Abdominal Surgery

Cited by 231 publications

References 0 publications

Immediate changes in biochemical markers of bone turnover and circulating interleukin-6 after parathyroidectomy for primary hyperparathyroidism

Immediate changes in biochemical markers of bone turnover and circulating interleukin-6 after parathyroidectomy for primary hyperparathyroidism

Association of Obesity With Inflammation and Pain After Total Hip Arthroplasty

Steroid cover for dental patients on long-term steroid medication: proposed clinical guidelines based upon a critical review of the literature

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